Neonatal convulsions: aetiology, late neonatal status and long-term outcome

Neonatal convulsions. Incidence and causes in the Stockholm area

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.