Neonatal seizure and short-term outcomes in hospitalized neonates

Background: Neonatal seizure is a common problem and associated with a great mortality rate, high risk of chronic neurodevelopmental impairments, also difficult to diagnosis and treatment. The aim of this study was to determine the neurodevelopmental outcome, clinical presentation and etiology of seizures in neonates admitted to Amirkola Children's Hospital (ACH). Methods: In this cross-sectional study, 42 neonates with the initial diagnosis of seizure, aged less than 28 days, hospitalized in ACH, northern Iran, from April to September 2016 were selected using convenient sampling method. The patients' information was gathered during hospitalization period and 6 months after discharge. Data were analyzed using SPSS 22 through descriptive and chi-square tests. Results: Among preterm and term neonates with seizures, the main diagnosis in neonates with seizures was idiopathic (38.1%) and hypoxicischemic encephalopathy (HIE) (14.3%), hypoglycemia (9.5 %) hypomagnesaemia (7.1%) and opiate withdrawal (4.8%). Twenty-three neonates underwent brain computed tomography (CT) scan and 6 (14.3%) of them had abnormal brain imaging. Seizure control with antiepileptics (P=0.006), metabolic disturbance (P=0.002) and time of drug discontinuation (P<0.001) were significantly associated with adverse neurodevelopmental outcome. Conclusions: Since idiopathic encephalopathy and HIE were the most common cause of neonatal seizures, it should be attempted to improve care during delivery.