Elsevier

The Journal of Pediatrics

Volume 113, Issue 3, September 1988, Pages 546-552
The Journal of Pediatrics

Cluster of perinatal events identifying infants at high risk for death or disability

https://doi.org/10.1016/S0022-3476(88)80649-8Get rights and content

To determine the prognostic import of neonatal seizures according to the presence or absence of certain other postnatal characteristics, we studied a population of 39,000 infants with birth weight >2500 gm. Children with clinically recognized neonatal selzures and 5-minute Apgar scores ≤5 and who had at least one of five signs compatible with neonatal encephalopathy had a risk for first-year death of 33%. Survivors of this cluster of events (low Apgar score-abnormal signs-seizures) had a risk for motor disability of 55%. In contrast, survivors of neonatal selzures who did not have poor Apgar scores or other abnormal signs had a risk for motor disability of only 0.13%. Thus, among infants with neonatal seizures the risk for cerebral palsy was 420 times greater if there had been a low 5-minule Apgar score and other neonatal signs. Low Apgar score-abnormal signs-seizures constituted a cluster of events that served to identify, within the first days of life, a finy subgroup of term newborn infants in whom risk for chronic motor disability was 55%, and for death or disability was 70%.

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