Background: Seizures in the newborn represent the most distinctive frequent manifestations of neurological dysfunction in the neonatal period. Globally, the neonatal seizure has an incidence of up to 1.5–3.5 per 1000 live birth in full-term infants and 10–130 per 1000 live birth in preterm infants. This greater variability of the reported incidence across various studies is primarily the result of inconsistent diagnostic criteria, as well as the often-subtle clinical manifestations of neonatal seizures, and their potential confusion with non-epileptic neonatal behaviors. Various studies in Africa have shown low numbers of neonatal seizures much less than the anticipated figure to match a higher percentage of available risk factors. This could be attributed to the limited number of researches about the neonatal seizure in the area. Again, locally, there is a paucity of data on the magnitude of neonatal seizures, therefore this study aims to establish the prevalence of neonatal seizures their associated risk factors, and the immediate outcomes among neonates in Tanzania. Objectives: To determine the prevalence of neonatal seizure, its associated risk factors, and the immediate outcomes in the neonates admitted to the Bugando Medical center.
Method: This was a hospital-based cross-sectional study, which was conducted among neonates with seizures admitted at Neonatology unity at Bugando Medical center. A structured questionnaire was used to collect demographic and all available clinical information. Proportion was used to summarize the overall prevalence of neonatal seizures. Chi squire and where applicable Fischer’s exact test was used to determine the association between categorical variables. A probability value (p) value of < 0.05 was considered statistically significant.
Results; The study included 126 neonates who were admitted at neonatology unit at Bugando medical centre. Majority of participants were full-term (77.0%) with a mean gestational age of 37.3 weeks. Vaginal birth was the most common type of delivery (72.2%), and cephalic presentation was the most frequent mode of delivery (77.8%). The study participants had predominantly normal birth weights (73.8%) with a mean birth weight of 2.86 ± 0.91. The Apgar scores at 1st and 5th minutes showed good overall muscle tone and reflexes, with 77.0% of babies scoring 7 and 8. The prevalence of neonatal seizures among the participants was 41.3%. Risk factors significantly associated with neonatal seizures included delayed cry after birth, meconium aspiration, and oxygen therapy. Neonatal Sepsis was the most frequently observed disease (20.9%), followed by Birth Asphyxia (16.1%) and Neonatal Jaundice (15.7%). The prevalence of seizures varied among different diagnoses, with Meconium Aspiration and Birth Asphyxia showing high seizure prevalence. The duration of hospitalization did not significantly impact the prevalence of neonatal seizures. Additionally, there was no significant association between the presence of seizures and the immediate outcome after 28 days.
Conclusion; Nearly three quarters of the neonates admitted at BMC experiences neonatal seizures occurring highly in neonates who had birth asphyxia, meconium aspiration, neonatal sepsis and neonatal jaundice. However most of these neonates recovered fully and were discharged while others died and few of them were lost to follow up.