Elsevier

The Journal of Pediatrics

Volume 154, Issue 1, January 2009, Pages 24-28.e1
The Journal of Pediatrics

Original article
Antenatal and Intrapartum Risk Factors for Seizures in Term Newborns: A Population-Based Study, California 1998-2002

https://doi.org/10.1016/j.jpeds.2008.07.008Get rights and content

Objective

To assess antenatal and intrapartum risk factors for seizures occurring during the birth admission.

Study design

Using multivariable logistic regression analysis, we evaluated the association between maternal characteristics and birth admission seizures in a cohort of 2.3 million California children born at ≥36 weeks' gestation between 1998 and 2002 using the California Office of Statewide Planning and Development database containing birth certificates linked to infant and maternal hospital discharge abstracts.

Results

The incidence of seizures during the birth admission was 0.95/1000 live births. In an adjusted analysis, infants of women age 40 years and older who were nulliparous; had diabetes mellitus, intrapartum fever, or infection or delivered at ≥42 weeks had an increased risk of seizures. Infants of Hispanic and Asian mothers had a lower risk compared with infants of Caucasian mothers.

Conclusions

Several maternal antenatal and intrapartum factors increased the risk of seizures during the birth admission. Identifying and avoiding risks for neonatal seizures may lead to lower infant neurologic morbidity and mortality.

Section snippets

Methods

We examined a population-based cohort using a California Office of Statewide Planning and Development (OSHPD)-linked Vital Statistics/Patient Discharge Data file created specifically to study perinatal outcomes.12 The linkage was performed using probabilistic record-linking techniques. The matched file links 97% of California birth certificates to the corresponding newborn and maternal hospital discharge record (www.health-info-solutions.com/links.html). The data set includes demographic data

Results

Of the 2 332 803 infants born at ≥36 weeks' gestation in California during the 4-year study period, 2 213 were diagnosed with seizures during the birth admission, for a population incidence of 0.95/1000. The annual incidence of seizures did not change significantly during the study period. The mean gestational age at birth was similar in newborns with and without seizures (39.8 vs 39.9 weeks; P = .60). The affected group had a higher proportion of males (57.3% vs 50.9%; P = .002) and a smaller

Discussion

This population-based study identifies antenatal and intrapartum risk factors for seizures in infants ≥36 weeks' gestation at birth. The incidence of seizures during the birth admission (0.95 per 1000) was on the lower end of what has been observed for neonatal seizures in other studies, which ranges from 1 to 3.5 per 1000 in term infants.1, 2, 3, 4, 5, 6 The lower incidence of seizures in the present study likely reflects a difference in case definition; other studies included seizures up to

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  • Cited by (0)

    The work of Hannah Glass was supported by a NINDS Neurological Sciences Academic Development Award (NS01692). The authors declare no conflicts of interest.

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