The epidemiology of clinical neonatal seizures in Newfoundland: A population-based study

Objective: To study the incidence, clinical features, etiologic distributio n, and day of seizure onset by etiology in neonates with seizures. Design: Prospective, population-based study involving all the obstetric and neonatal units across the province of Newfoundland, Canada. hll units were given educational sessions on neonatal seizure symptomatology. Subjects: Del:ailed questionnaires were prospectively collected for all inf ants with probable neonatal seizures for a period of 5 years. Results: The incidence rate was 2.6 per 1000 live births, 2.00 for term neo nates, 11.1 for preterm neonates, and 13.5 for infants weighing <2500 g at birth. Seizures lasting 30 minutes or longer were present in 5%, and the ne onatal death rate among infants with seizures was 9%. Hypoxic-scheme enceph alopathy was the presumed cause in 40%, infections in 20%, and metabolic ab normalities in 19%. Conclusions: Clinical neonatal seizures occur 6 times more often in preterm infants than in term infants. Hypoxic-ischemic encephalopathy continues to be a major marker of the likelihood of seizures.