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Neonatal convulsions. Incidence and causes in the Stockholm area
Insights
Hypoxia was the main cause of neonatal convulsions in infants, leading to poor prognoses. Many infants experienced severe psychomotor retardation or developed cerebral palsy and epilepsy by one year of age.
Area of Science:
- Neonatal neurology
- Pediatric neurology
- Perinatal medicine
Background:
- Neonatal convulsions are a critical concern in newborns.
- Understanding the causes and outcomes is vital for clinical management.
Purpose of the Study:
- To investigate the etiology and short-term prognoses of neonatal convulsions.
- To analyze outcomes at one year of age in affected infants.
Main Methods:
- Retrospective study of 77 full-term infants born in Stockholm (1970-1976).
- Data collection on etiology, mortality, and neurodevelopmental outcomes at 12 months.
Main Results:
- Hypoxia was the primary cause in 48% of cases.
- Infection and metabolic diseases (hypoglycemia, hypocalcemia) each accounted for 12%.
- Mortality was 13%; 30% of survivors had severe psychomotor retardation, and 53% showed no sequelae.
Conclusions:
- Hypoxia is associated with the poorest prognosis in neonatal convulsions.
- Neonatal convulsions can lead to significant long-term neurodevelopmental impairments.
- The incidence of neonatal convulsions and perinatal mortality has decreased over time.
Abstract:
The causes and short-term prognoses of neonatal convulsions in infants less than four weeks of age were studied in 77 full-term infants born in Stockholm in 1970--1976. In half of the infants (48%), hypoxia was considered to be the probable main etiology, while infection and metabolic disease including hypoglycemia and hypocalcemia were the next commonest cause, 12% for each condition. The etiology was unknown in 29% of the infants although 15 of those 22 included in this group had other additional diagnoses. The total mortality was 13%. At one year of age, 19 of the surviving 64 infants (30%) had severe psychomotor retardation. Of 11 infants with normal mental development at 12 months of age 6 had cerebral palsy and 5 epileptic seizures. Thirty-four (53%) of the infants still had no signs of sequelae. The poorest prognosis was found in the group with hypoxia as the main probable etiology. The incidence of neonatal convulsions was 1.5 per 1 000 full-ferm deliveries. In a similar study from Gothenburg which was performed 10 years earlier the incidence was 3.7 per 1 000. Corresponding figures for perinatal mortality rate were 13.5 and 23.8.