Neonatal seizures: Predictors of adverse outcome.

Abstract

Context:Early detection of predictors of adverse outcome will be helpful for neonatologists to plan management, follow up and rehabilitation in advance so that neurological disability can be minimised.Aims:The purpose of this study was to determine the factors affecting the adverse outcome of neonatal seizures.Settings and Design:This is a prospective study conducted in the neonatal unit of a tertiary care hospital. One hundred and eight newborns consecutively admitted with seizures were included in this study.Materials and Methods:Data was collected regarding perinatal history and seizure and evaluated for etiology. We conducted a retrospective analysis to identify the factors associated with adverse outcome after neonatal seizures.Statistical Analysis Used:Chi-square test with degree of freedom = 1 was used to find the variables significantly associated with adverse outcome (P < 0.05).Results:Gestational age, birth weight, Apgar score at 5 min, seizure onset <24 hrs, status epilepticus, radiological findings and EEG findings were significantly associated with outcome.Conclusion:Mortality and severe neurological impairment after neonatal seizure is associated with prematurity, LBW, low Apgar score at 5 min, etiologies like meningitis, sepsis, severe HIE, brain malformations, grade 3 or 4 IVH or intracranial haemorrhage, seizure onset <24 hours, presence of status epilepticus, severely abnormal radiological and EEG findings.