Neurological outcome of newborns with neonatal seizures: a cohort study in a tertiary university hospital

Abstract

Objective: To describe the neurological outcome of newborns with seizures.

Method: Cohort study with newborns prospectively followed. Perinatal characteristics and etiological screening were related to outcome in a regression model.

Results: During the study 3,659 newborns were admitted and 2.7% were diagnosed as having seizures. Hypoxic ischemic encephalopathy (51%) was the etiology more frequently associated to seizures and also to postneonatal epilepsy (53%). In the follow up 25 died during the acute neonatal illness and 9 during the first years of life, 19 were diagnosed as having post neonatal epilepsy, 35 had developmental delay and 11 an association among this two comorbidities. A significant association between abnormal postnatal EEG and neuroimaging to developmental delay (p=0.014, p=0.026) was observed. The group of newborns that had seizures presented an increased risk of developing epilepsy compared to newborns from the same cohort without seizures (19.3/100 vs. 1.8/100, p<0.001).

Conclusion: In this study neonatal seizures predominated in term newborns with perinatal asphyxia an elevated perinatal mortality and post neonatal morbidity was observed. The follow up showed an increased risk for developing postnatal epilepsy and developmental delay.