Jostein Lappegård, Ulrik Båtstrand Lyeng, Ragnhild Støen, Dag Moster, Anlaug Vatne, Tone Nordvik, Beate Horsberg Eriksen, Ingebjørg Fagerli, Arild Erland Rønnestad, Claus Klingenberg
Acta Paediatrica, Volume 115, Issue 6, Page 1202-1209, June 2026.
Aim
This study described the aetiological factors associated with neonatal seizures and the risks for adverse neurological outcomes.
Methods
We identified all infants born at ≥ 36 weeks of gestation between 2009 and 2015 who were diagnosed with or treated for neonatal seizures and registered in the Norwegian Neonatal Network. Data from four nationwide registries provided information on perinatal factors and neurological outcomes until 5 years of age.
Results
There were 892 infants with seizures, which was an incidence of 2.2 per 1000 live births. More than half (58.5%) underwent electroencephalography monitoring and examinations. Mortality before discharge was 8.4% and deaths occurred a median of 5 days after birth. The most frequent presumed aetiology for neonatal seizures was moderate to severe hypoxic-ischaemic encephalopathy (25.1%). Of the 817 survivors, 115 (14.1%) were diagnosed with post-neonatal epilepsy, 119 (14.6%) with cerebral palsy (CP), and 43 (5.3%) had both diagnoses. The epilepsy risk was greatest after neonatal encephalopathy with normal Apgar scores (40.9%) and the CP risk was greatest after an ischaemic stroke (29.9%).
Conclusion
Neonatal seizures were associated with a high risk of mortality and about a quarter were later diagnosed with epilepsy and/or CP. Improved access to electroencephalography and higher usage could improve diagnostics.
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