Early-onset neonatal seizures: types, risk factors and short-term outcome.
In a large majority of term newborns, early-onset neonatal seizures (EONS) are believed to relate to perinatal risk factors.


OBJECTIVE
To identify risk factors for EONS.


METHODS
Among a cohort of 1293 newborns admitted over a period of 2 years to the neonatal intensive care unit of Tikur Anbasa Hospital, Addis Ababa, 93 had seizures. The case control study method was used to identify risk factors associated with EONS. Univariate analysis was used to further examine risk factors after adjusting for the effect of severe perinatal asphyxia (Apgar < or = 3).


RESULTS
A total of 78 (85%) term newborns had EONS. Hypoxic-ischaemic encephalopathy (OR 3.46, 95% CI 2.74-7.42) and shock (OR 2.53, 95% CI 1.51-4.76) were significantly associated with EONS. Multifocal clonic (66%) followed by focal clonic (22%) were the most common types of EONS. Nine (11%) of the newborns with EONS died. During follow-up, 37 (53%) of the 69 surviving newborns with EONS had psychomotor delay with or without neurological deficit.


CONCLUSIONS
Hypoxic-ischaemic encephalopathy and shock are important causes of EONS.
Gebremariam
Ayele
A
Department of Pediatrics and Child Health, Medical Faculty, Addis Ababa University, Ethiopia. agebremar12@yahoo.com
Gutema
Yoseph
Y
Leuel
Abadi
A
Fekadu
Habtamu
H
D001034:Apgar Score; D016022:Case-Control Studies; D005002:Ethiopia; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications*; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012769:Shock / Q000150:complications*; D013036:Spasms, Infantile / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate