Causes and Short-Term Outcomes of Neonatal Seizures in the Neonatal Intensive Care Unit at Omdurman Maternity Hospital: A Prospective Study (March-August 2022)

Abstract

Introduction: The aim of this study was to determine the causes of neonatal seizures and assess short-term outcomes in neonates admitted to the Neonatal Intensive Care Unit at Omdurman Maternity Hospital. Methods: A prospective, cross-sectional, hospital-based study was conducted at Omdurman Maternity Hospital involving 103 inborn neonates with clinically observed or reported seizures. Data were collected using a structured questionnaire and analyzed with the Statistical Package for the Social Sciences version 26.0. Results: Among the 103 neonates studied, 65 (63.1%) were male and 80 (77.7%) were full-term. Low birth weight (< 2.5 kg) was noted in 16 cases (15.5%). Seizures occurred within the first week of life in 98 of the neonates (95.1%). Subtle and clonic seizures were the most frequent types of seizures, each occurring in 35 cases (34%). The most common underlying causes were Hypoxic-Ischemic Encephalopathy (HIE), in 51 cases (49.5%) and sepsis, in 49 cases (47.6%). In terms of outcomes, 48 of the neonates (46.6%) were discharged after achieving seizure control, 31 (30.1%) developed neurological deficits and 24 (23.3%) died. Poor outcomes were significantly associated with low Apgar scores at 1 minute (P = 0.001) and 5 minutes (P < 0.001), the need for resuscitation at birth (P < 0.001), prematurity (P = 0.019) and seizures due to HIE (P < 0.001). Conclusion: We found that neonatal seizures predominantly occurred in full-term males within the first week of life, with HIE and sepsis being the leading causes. Subtle and clonic seizures were the most common types of seizures. Efforts to address preventable causes and provide timely intervention can improve neonatal outcomes.