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Does the Onset of Neonatal Seizures Correlate with the Timing of Fetal Neurologic Injury?

Department of Obstetrics and Gynecology, Cha Women's Hospital, Seoul, Korea

Lisa M. Korst, MD

Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA

Jeffrey P. Phelan, MD

Maternal-Fetal Medicine, Pomona Valley Hospital Medical Center, Pomona, CA; Suite 200, 959 East Walnut Street, Pasadena, CA 91106

Gilbert I. Martin, MD

Neonatology, Citrus Valley Medical Center, Queen of the Valley Campus, West Covina, California, Pediatrics Medical Group

The onset of seizures after birth has been considered evidence of an intrapartum asphyx-ial event. The present study was undertaken to determine whether the timing of neonatal seizures after birth correlated with the timing of a fetal asphyxial event. Thus, singleton term infants diagnosed with hypoxic ischemic encephalopathy and permanent brain injury had a mean birth to seizure onset interval of 9.8 ± 17.7 (range 1-90) hours. When these infants were categorized according to their fetal heart rate (FHR) patterns, the acute group (normal FHR followed by a sudden prolonged FHR deceleration that continued until delivery) tended to have earlier seizures than infants did within the tachycardia group (normal FHR followed by tachycardia, repetitive decelerations, and diminished variability) and the preadmission group (persistent nonreactive FHR pattern intrapartum). These seizure intervals were as follows: acute, 6.6 ± 18.0 (range 1-90) hours; tachycardia, 11.1 +17.1 (range 1-61) hours; and preadmission, 11.8 +17.9 (range 1-79) hours (p<0.05). But the range varied widely and no group was categorically distinct. In conclusion, the onset of neonatal seizures after birth does not, in and of itself, appear to be a reliable indicator of the timing of fetal neurologic injury.

Clinical Pediatrics, Vol. 37, No. 11, 673-676 (1998)
DOI: 10.1177/000992289803701105


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