Subscribe to RSS
DOI: 10.1055/s-0040-1712487
Risk Factors for Mortality among Newborns with Neonatal Seizures
![](https://www.thieme-connect.de/media/neuropediatrics/202102/lookinside/thumbnails/10-1055-s-0040-1712487_192278oa-1.jpg)
Abstract
Objective The aim of the study is to examine the incidence and risk factors for death among neonates who developed neonatal seizures (NS) in an ethnically distinctive community with high consanguinity rate in Israel.
Methods Retrospective study was conducted at a single institution on data between January 2001 and January 2016. All neonates diagnosed with NS developed up to age 28 days were included. Mortality was defined as death within the first year of life.
Results Of all 69,460 neonates born during the study period, 118 (1.7 per 1,000 live births) developed NS; 35 (29.7%) died within the first year while 83 (70.3%) survived. The leading causes of death were developmental brain malformation (31.4%), genetic/metabolic (20%), hypoxic ischemic encephalopathy (20%), intracranial hemorrhage (11.4%) and infections (11.4%). Any consanguinity between the parents was found in 18 and 14.6% among the survivors and deceased groups, respectively (p = 0.24). Developmental brain malformations that lead to death were present in 3.6 and 31.4% in the survivors and deceased groups, respectively (p = 0.001; relative risk 8.70; 95% confidence interval 2.58–29.27). Stepwise backward logistic regression analysis revealed that developmental brain malformations (p < 0.0001), use of more than one antiepileptic medication (p = 0.006), and multiorgan failure (p = 0.004) were significant risk factors that predicted death.
Conclusion The results of the current study show that developmental brain malformations that cause NS were the leading risk factor for death.
Financial Disclosure
All authors have indicated they have no financial relationships relevant to this article to disclose.
Table of Contents Summary
Characteristics of the community examined may determine the major risk factors for neonatal seizures and as a consequence negatively affect the neonatal mortality rate.
Contributors' Statement Page
O.T. and R.S. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. M.W. designed the data collection instruments, collected data, performed the initial analyses, and reviewed and revised the manuscript. C.F.-F., M.P., and D.M. conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Publication History
Received: 16 July 2019
Accepted: 13 April 2020
Article published online:
22 October 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Levene M. The clinical conundrum of neonatal seizures. Arch Dis Child Fetal Neonatal Ed 2002; 86 (02) F75-F77
- 2 Bassan H, Bental Y, Shany E. et al. Neonatal seizures: dilemmas in workup and management. Pediatr Neurol 2008; 38 (06) 415-421
- 3 Vasudevan C, Levene M. Epidemiology and aetiology of neonatal seizures. Semin Fetal Neonatal Med 2013; 18 (04) 185-191
- 4 Sands TT, McDonough TL. Recent advances in neonatal seizures. Curr Neurol Neurosci Rep 2016; 16 (10) 92
- 5 Lanska MJ, Lanska DJ, Baumann RJ, Kryscio RJ. A population-based study of neonatal seizures in Fayette County, Kentucky. Neurology 1995; 45 (04) 742
- 6 Lanska MJ, Lanska DJ. Neonatal seizures in the United States: results of the National Hospital Discharge Survey, 1980-1991. Neuroepidemiology 1996; 15 (03) 117-125
- 7 Saliba RM, Annegers JF, Waller DK, Tyson JE, Mizrahi EM. Incidence of neonatal seizures in Harris County, Texas, 1992-1994. Am J Epidemiol 1999; 150 (07) 763-769
- 8 Ronen GM, Penney S, Andrews W. The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study. J Pediatr 1999; 134 (01) 71-75
- 9 Glass HC, Pham TN, Danielsen B, Towner D, Glidden D, Wu YW. Antenatal and intrapartum risk factors for seizures in term newborns: a population-based study, California 1998-2002. J Pediatr 2009; 154 (01) 24-28.e1
- 10 Murray DM, Boylan GB, Ali I, Ryan CA, Murphy BP, Connolly S. Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures. Arch Dis Child Fetal Neonatal Ed 2008; 93 (03) F187-F191
- 11 Anand V, Nair PMC. Neonatal seizures: predictors of adverse outcome. J Pediatr Neurosci 2014; 9 (02) 97-99
- 12 Heljic S, Uzicanin S, Catibusic F, Zubcevic S. Predictors of mortality in neonates with seizures; A prospective cohort study. Med Arh 2016; 70 (03) 182-185
- 13 Legido A, Clancy RR, Berman PH, Legido A, Clancy RR, Berman PH. Neurologic outcome after electroencephalographically proven neonatal seizures. Pediatrics 1991; 88 (03) 583-596
- 14 Pisani F, Facini C, Pelosi A, Mazzotta S, Spagnoli C, Pavlidis E. Neonatal seizures in preterm newborns: a predictive model for outcome. Eur J Paediatr Neurol 2016; 20 (02) 243-251
- 15 Israeli Ministry of Health. . Neonatal Screening. 2015 . Accessed May 14, 2020 at: https://www.health.gov.il/English/Topics/Genetics/InfantScreening/Pages/default.aspx
- 16 Kang SK, Kadam SD. Neonatal seizures: impact on neurodevelopmental outcomes. Front Pediatr 2015; 3: 101
- 17 Olson DonaldM. Neonatal seizures. Neoreviews 2012; 13 (04) e213-e223
- 18 Pavlidis E, Spagnoli C, Pelosi A, Mazzotta S, Pisani F. Neonatal status epilepticus: differences between preterm and term newborns. Eur J Paediatr Neurol 2015; 19 (03) 314-319
- 19 Pisani F, Sisti L, Seri S. A scoring system for early prognostic assessment after neonatal seizures. Pediatrics 2009; 124 (04) e580-e587
- 20 Glass HC, Shellhaas RA, Wusthoff CJ. et al; Neonatal Seizure Registry Study Group. Contemporary profile of seizures in neonates: a prospective cohort study. J Pediatr 2016; 174: 98-103.e1
- 21 Sheth RD, Hobbs GR, Mullett M. Neonatal seizures: incidence, onset, and etiology by gestational age. J Perinatol 1999; 19 (01) 40-43
- 22 Aziz A, Gattoo I, Aziz M, Rasool G. Clinical and etiological profile of neonatal seizures: a tertiary care hospital based study. Int J Res Med Sci 2015; 3 (09) 2198-2203
- 23 Sabzehei MK, Basiri B, Bazmamoun H. The etiology, clinical type, and short outcome of seizures in newborns hospitalized in Besat Hospital/Hamadan/Iran. Iran J Child Neurol 2014; 8 (02) 24-28
- 24 Ching Hu S, Hung KL, Chen HJ. Neonatal seizures: incidence, etiologies, clinical features and EEG findings in the neonatal intensive care unit. Epilepsy J 2017; 3: 3-5
- 25 Badran EF, Masri AT, Hamamy H, Al-Qudah AA. Etiological and clinical profile of neonatal seizures in a highly consanguineous population. J Pediatr Neurol 2007; 5 (04) 305-309
- 26 Malone A, Ryan CA, Fitzgerald A, Burgoyne L, Connolly S, Boylan GB. Interobserver agreement in neonatal seizure identification. Epilepsia 2009; 50 (09) 2097-2101
- 27 McBride MC, Laroia N, Guillet R. Electrographic seizures in neonates correlate with poor neurodevelopmental outcome. Neurology 2000; 55 (04) 506-513
- 28 Cross JH. Differential diagnosis of epileptic seizures in infancy including the neonatal period. Semin Fetal Neonatal Med 2013; 18 (04) 192-195