Clinically diagnosed neonatal seizures in Al- Diwanyah, an epidemiological study
Neonatal seizures are the most frequent and distinctive manifestations of neurological disturbances during the neonatal period. This retrospective study aimed to determine the incidence rate, causes and risk factors for neonatal seizures in Al-Diwanyah Province during one calendar year from the 1st of January, 2016 to 31st December, 2016
METHODS.Data were extracted from the records at Maternity and children Teaching Hospital in Al-Diwaniyah. All neonates who had developed clinically recognized seizures before 28 days of life were enrolled in the study. These data included gestational age (full or pre-term infant), maternal diseases and drug intake during the last trimester, family history of seizures, number of parities, consanguinity, mode of delivery (normal vaginal delivery or caesarian section) age and gender of neonate, body weight at birth (normal or low body weight), and age at which seizure has developed (early onset or delayed onset). Biochemical tests were blood sugar and serum calcium.
Out of 3167 recorded birth in the hospital, 113 neonates have developed seizure with overall incidence rate of 3.57%. Four main causes of seizures were recognized which were: asphyxia (34.5%), hypoglycemia (23%), hypocalcemia (14.16%) and intraventricular hemorrhage (7.08%). However, in 21.42% of cases, the cause(s) was/were undiagnosed.
Three risk factors (gender, family history of seizures and number of parities) were found to have no significant association with any of these causes of seizures. The other risk factors associated with these causes in different modes. Each of early onset of seizure, mother’s disease during pregnancy, caesarian section delivery and full term infant were significantly associated with hypoglycemia. Hypocalcemia, on the other hand, was significantly associated with delayed onset of seizures and preterm infants with low body weight, while there was very significant association between asphyxia and normal vaginal delivery. Although less frequent than other causes of seizure, intraventricular hemorrhage was found to be significantly associated with three risk factors (delayed onset of seizures, normal vaginal delivery and preterm infants). Finally, a positive significant association was found between consanguinity and undiagnosed causes of seizures
These results pointed out the importance of asphyxia and hypoglycemia as the main causes of neonatal seizures. The most important risk factors associated with these causes are normal vaginal delivery, mother’s disease during pregnancy, and low body weight at birth.