TOPLINE:

In infants born at or beyond 36 weeks of gestation, neonatal seizures were associated with high in-hospital mortality before discharge, most commonly due to hypoxic‑ischaemic encephalopathy, and about a quarter of survivors developed epilepsy, cerebral palsy, or both by 5 years of age.

METHODOLOGY:

• Researchers in Norway conducted a nationwide population-based study to determine the incidence and underlying causes associated with neonatal seizures in infants born at or beyond 36 weeks of gestation and to evaluate the risk for adverse neurologic outcomes.
• They used registry data and included 892 term-born infants (57.7% boys) who were diagnosed with neonatal seizures and underwent treatment between 2009 and 2015.
• Researchers assessed the rate of mortality at discharge and the occurrence of post-neonatal epilepsy and cerebral palsy up to 5 years of age among survivors.

TAKEAWAY:

• The overall incidence of neonatal seizures among infants was 2.2 per 1000 live births; 58.5% of affected infants underwent EEG monitoring, and approximately 40% were diagnosed clinically without EEG.
• Moderate-to-severe hypoxic-ischaemic encephalopathy was the most frequent presumed underlying cause of neonatal seizures (25.1%), followed by ischaemic stroke (8.6%) and intracranial haemorrhage (6.3%).
• The in-hospital mortality rate before discharge was 8.4%, with deaths occurring a median of 5 days after birth and being notably higher in infants with hypoxic-ischaemic encephalopathy than in those with seizures due to other causes (20.1% vs 4.5%; P < .001).
• Among 817 infants discharged alive, 14.1% developed post-neonatal epilepsy, 14.6% developed cerebral palsy, and 5.3% developed both, with the highest risk for post-neonatal epilepsy seen after neonatal encephalopathy with normal Apgar scores and the higher risk for cerebral palsy seen after an ischaemic stroke; antiseizure therapy was linked to higher rates of epilepsy and cerebral palsy.

IN PRACTICE:

"Our findings contribute to increased knowledge about the risk factors, aetiological causes and prognoses of neonatal seizures in term infants," the authors wrote.

SOURCE:

This study was led by Jostein Lappegård, University Hospital of North Norway, Tromsø, Norway. It was published online on January 29, 2026, in Acta Paediatrica.

LIMITATIONS:

The study relied on registry data without individual chart review, limiting diagnostic precision. EEG was performed in only about half of cases, increasing the risk of misclassifying seizures diagnosed on clinical grounds alone. Nearly one quarter of cases had an unknown aetiology, and the lack of routine genetic and metabolic testing may have underestimated underlying causes and affected outcome estimates.

DISCLOSURES:

This study did not report any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.