Changes in Risk Factors for Hypoxic‐ischaemic Seizures in Term Infants

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Abstract
Summary: Term infants with seizures and evidence of perinatal asphyxia were prospectively identified in 1 city and 2 time periods: 1978–1981 and 1991. Infants with multiple congenital abnormalities, hypocalcaemia or infection were excluded. Although there was little change in the overall incidence of neonatal seizures between 1978–1981 (1.9 per 1,000) and 1991 (1.78 per 1,000, N.S.) there was a marked reduction in small for dates infants with seizures: 8 of 19 infants in 1978–1981 compared to none of 16 in 1991 (p<0.005). In contrast, infants ≥41 weeks continued to show a markedly increased risk for asphyxia (relative risk 4.48,95% CI: 1.7–12.3). The mechanism of this improved outcome for small for gestational age infants is unknown, but speculatively may be due to improved obstetric monitoring techniques allowing early identification of compromised infants.