Incidence of neonatal seizures in a selected birth cohort from Colombo District, Sri Lanka

Background: Seizures are commoner in the neonatal period than any other time. Incidence of clinical seizures in term infants is around 3 per 1000 live births, whereas in preterm infants, it is as high as 57 to 130 per 1000 live births. Currently, there is no local data on this disease burden.
Objectives: To determine the incidence of neonatal seizures in term and preterm babies in a birth cohort of neonates born in the premier maternity hospitals in the Colombo district.
Method: A prospective follow-up was done of a birth cohort in Colombo city over a period of 3 months. All newborns born in the 2 premier maternity hospitals in the city from 1st June to 31st July 2017 were recruited. They were followed up over 28 days (neonatal period) for development of clinical seizures. All deliveries before completion of 37 weeks of gestation were considered as preterm.
Results: Total number of births during this period was 2906. Number of intrauterine or neonatal deaths was eight. Number of neonatal intensive care admissions was 73. There were 2410 children followed up during the first 28 days for development of seizures (2198 term deliveries and 212 preterm deliveries). Number lost for follow up was 496. Total number of babies who developed neonatal seizures was 11 (nine term and two preterm babies). The onset of seizures was within 24 hours in 5, 1-7 days in 2 and after 7 days in 4. There were two deaths at one year follow up. The incidence of neonatal seizures in this birth cohort of children born in the two main maternity hospitals in the Colombo city was 4.5 per 1000 live births: 3.6 per 1000 for term babies and 14.1 per 1000 for pre-term babies.
Conclusions: The incidence of neonatal seizures in this birth cohort was 4.5 per 1,000 live births; higher rates were observed among preterm infants. These findings indicate a higher disease burden.