Clinical Characteristics and Risk Factors of Controlled Neonatal Seizures: A Single-Center Experience at Children’s Hospital of Bandar Abbas, Iran

Background: Seizure is defined by sudden and irreversible changes in the nervous system. It is the most common neurological symptom observed in neonates admitted to the neonatal intensive care unit (NICU). Hence, this study investigated the clinical characteristics and identified the potential risk factors associated with controlled neonatal seizures according to the number of medications used in neonates admitted to the neonatal ward and NICU of Bandar Abbas Children’s Hospital. Methods: This retrospective cross-sectional study was conducted using data from 150 neonates admitted to the neonatal ward and NICU of Bandar Abbas Children’s Hospital between 2019 and 2021. Patient data were obtained based on clinical examination, history, and information registered in hospital medical files, including demographic, clinical, and laboratory findings. Results: Among 150 neonates, the mean age was 6.89±6.46 days, of whom 93 (62%) were boys, and the mean weight was 2880.73±632.91 g. The delivery type was normal vaginal delivery in 81 (54%) patients. The mean 1-minute and 5-minute Apgar scores were 8±1 and 9± 1, respectively. The number of medications used by more than half of the newborns was one medication (58.7%), and phenobarbital was the most common anti-seizure medication (ASM) (80%). Hypoxic-ischemic encephalopathy (HIE) was the most prevalent (34%) risk factor for seizure. There was a significant association between inborn error of metabolism and kernicterus with the number of medications utilized to control seizures. Conclusion: HIE was the most common risk factor for neonatal seizures in newborns whose seizures were controlled with three or more medications compared to those who received one or two medications without a statistically significant difference.