Rajkumar Meshram, Saira Merchant and Chhagan Rakhade

Objective:Assessing the neonatal risk factors for seizure in first 72 hours of life in term neonate.

Design: Case control study.

Setting: Department of Paediatrics, Neonatology unit tertiary care centre Govt. Medical College, Nagpur.

Method:A 210 cases i.e. term neonate with seizure within first 72 hours of life and 210 controls i.e. term neonate without seizure in first 72 hours of life were randomly selected as study subject over a period of two year. Seizures were defined as per standard definition. Data were collected regarding age of onset of seizure, birth weight, Apgar score at 1 minute and 5 minute, type of delivery. Appropriate investigation was done and neonates were followed up till discharge or death

Results: In73% neonate’s subtle seizure was most common and occurs within 48-72 hours of life. Neonates with low birth weight had 0.22 times more risk of seizure than normal weight. Birth asphyxia was most significant risk factor for seizure and had 4.66 times more risk of seizure (P<0.001). Presence of low Apgar score at 1 minute and 5 minute are found to be significant in univariate analysis but in multiple logistic regression analysis it is found that 5 minute Apgar score is more significant than 1 minute. Low Apgar score at 5 minute had 1.29 times more risk of seizure. In study population 7.1% neonates died in case group compared to 1.4% in control group which was statistically highly significant (OR 3.98, 95% CI 1.23-16.7, P<0.0095) and most common cause of death was severe birth asphyxia and sepsis.