Background
Methods
Location
Study participants and definitions
Admission procedures
Data management and statistical considerations
Results
General description
Incidence
Clinical presentation, laboratory findings and diagnosis in neonates with seizures
Clinical presentation
Characteristics | Neonates with seizures, n= 142 | Neonates without seizures, n= 1430 | Crude odds ratio [OR (95 CI)] |
Pvalue | Adjusted OR (95% CI) |
PValue |
---|---|---|---|---|---|---|
Median (interquartile range) age, days | 6 (2-15) | 4 (0-11) | 1.04 (1.01-1.05) | 0.002 | 1.01 (0.99-1.03) | 0.44 |
Males (%) | 83 (58.5) | 840 (58.7) | 1.12 (0.75-1.49) | 0.75 | - | - |
Median weight (kg) [95%CI] | 2.94 [2.46-3.29] | 2.74 [2.04-3.18] | 6.21(1.0-38.7) | 0.05 | 1.00(0.99-1.00) | 0.52 |
Fever (%) | 75 (52.8) | 502 (35.1) | 2.14 (1.52-3.03) | <0.001 | 1.63 (1.10-2.43) | 0.02 |
Irritability (%) | 11(7.7) | 25 (1.7) | 4.61 (2.22-9.57) | <0.001 | 2.53 (1.04-6.17) | 0.04 |
Inability to breast feed (%) | 36 (25.4) | 503 (35.2) | 1.58 (1.08-2.33) | 0.02 | 1.13 (0.71-1.81) | 0.53 |
Bulging fontanel (%) | 14 (9.9) | 16 (1.0) | 10.22 (4.9-21.1) | <0.001 | 5.94 (2.65-13.30) | <0.001 |
Hypoglycaemia (%) | 23 (16.2) | 254 (17.7) | 0.91 (0.58-1.44) | 0.69 | - | - |
Hyponatraemia (%) | 4 (2.8) | 43 (2.9) | 0.92 (0.32-1.59) | 0.87 | - | - |
Hypernatraemia (%) | 3 (2.1) | 9 (0.6) | 3.34 (0.89-12.47) | 0.07 | - | - |
Hypokalaemia (%) | 12 (8.1) | 130 (8.9) | 0.90 (0.49-1.67) | 0.75 | - | - |
Hyperkalaemia (%) | 14 (9.5) | 119 (8.2) | 1.18 (0.66-2.11) | 0.58 | - | - |
Positive cerebral spinal fluid culture (%) | 9 (8.4) | 11 (1.9) | 14.01 (6.01-32.47) | <0.001 | 14.08 (3.60-55.09) | <0.001 |
Positive blood culture (%) | 10 (7.0) | 76 (5.3) | 1.32(0.67-2.61) | 0.80 | - | - |
Laboratory findings
Diagnoses
Characteristics | Incident neonatal admissions with seizures, n= 142 (%) | Incident neonatal admissions without seizures, n= 1430 (%) | Crude odds ratio (95% confidence interval) |
Pvalue |
---|---|---|---|---|
Neonatal sepsis | 89 (62.7) | 772 (54.0) | 1.27 (0.91-1.80) | 0.16 |
Prematurity | 3 (2.1) | 248 (17.3) | 0.10 (0.03-032) | <0.001 |
Neonatal encephalopathy | 30 (21.1) | 197 (13.7) | 1.63 (1.06-2.50) | 0.03 |
Neonatal jaundice | 17(12.0) | 372 (26.0) | 0.38 (0.23-0.64) | <0.001 |
Meningitis | 21(14.8) | 8 (0.6) | 34.4 (14.65-76.26) | <0.001 |
Neonatal tetanus | 3 (2.1) | 18 (1.3) | 1.04 (0.48-5.70) | 0.42 |
Immediate outcome of neonatal seizures
Discussion
The incidence of acute neonatal seizures
Diagnoses, inpatient outcome and implications for public health
Conclusion
Appendix
Definitions of discharge diagnoses
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abnormal temperature (>37.5°C or <35.5°C),
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multiple skin pustules,
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umbilical redness or pus,
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respiratory distress, lethargy, seizures or feeding problems.
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positive CSF culture,
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white cell count of >50/μL in CSF,
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positive bacterial antigen test or gram stain.
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where last monthly period is known and expected date of delivery can be calculated,
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acceptable gestation age estimation criteria with:
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ultrasound,
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◦ the Dubowitz.
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Neonatal encephalopathy
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No cry at birth, poor Apgar score (<7) at 5 min.
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An accompanying history of feeding problems, restlessness, agitation, hypotonia, hypertonia, seizures and coma, or similar symptoms and signs after excluding other possible.
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spasms that may be provoked or spontaneous,
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trismus.