Fetene Terefe Tamene, Alene Tamiru, Ayalneh Manay, Dessalegn Nigatu, Aragaw Gonete Yosef, Tsegaye Amlak Baye, Alebel GebreEyesus Fisha, Wondie Alemayehu, Bimerew Melaku
Department of Pediatrics and Child Health Nursing, Injibara University, Injibara, Ethiopia.
Department of Midwifery, Debark University, Debark, Ethiopia.
Sci Rep. 2025 Jul 29;15(1):27692. doi: 10.1038/s41598-025-98628-2.
Neonatal seizures were associated with significant rates of mortality; in which about one-third of the neonates with seizure ending up with death. Despite this, the time to death and its predictors among neonates with seizure has not been investigated; especially in Ethiopia. To determine the time to death and its predictors among neonates with seizure in public hospitals of Awi zone, Northwest Ethiopia. A multicenter prospective follow-up study was conducted in public hospitals of Awi zone on 263 neonates with seizure. Descriptive statistics, Kaplan-Meier curve, Nelson-Aalen curves, and log-rank tests were employed to describe the time to death and to assess the risk of mortality among different covariates. The Cox proportional hazards model was used to identify the predictors of time to death. AHR with 95% CI was used to identify significant predictor variables, and a statistical significance was declared at p-value < 0.05. A total of 263 neonates with seizure were followed for a total of 1334.3 person-days, and the incidence of mortality was found to be 22.5 per 1000 person-day observations (95% CI = 14.0-29.6). The median time to death was 3 days (IQR = 2-5 days). Birth trauma (AHR = 3.9, 95% CI = 1.5-10.6), neonatal sepsis (AHR = 3.4, 95% CI = 1.1-10.8), hypoglycemia (AHR = 3.2, 95% CI = 1.1-9.3), and tonic type seizure (AHR = 4.5, 95% CI = 1.3-15.6) were statistically significant predictors of early mortality in neonates with seizure. This study revealed that the incidence of in-hospital mortality among neonates with seizure to be high and the median time to death to be short; and the predictors of early mortality were identified. Early detection and appropriate management of neonates having birth trauma, sepsis, and hypoglycemia might be helpful.
新生儿惊厥与显著的死亡率相关；其中约三分之一的惊厥新生儿最终死亡。尽管如此，惊厥新生儿的死亡时间及其预测因素尚未得到研究；尤其是在埃塞俄比亚。为了确定埃塞俄比亚西北部阿维地区公立医院中惊厥新生儿的死亡时间及其预测因素。在阿维地区的公立医院对263例惊厥新生儿进行了一项多中心前瞻性随访研究。采用描述性统计、Kaplan-Meier曲线、Nelson-Aalen曲线和对数秩检验来描述死亡时间并评估不同协变量之间的死亡风险。使用Cox比例风险模型来确定死亡时间的预测因素。采用95%置信区间的调整后风险比来确定显著的预测变量，p值<0.05时具有统计学意义。共对263例惊厥新生儿进行了总计1334.3人日的随访，发现死亡率为每1000人日观察22.5例（95%置信区间=14.0-29.6）。中位死亡时间为3天（四分位间距=2-5天）。出生创伤（调整后风险比=3.9，95%置信区间=1.5-10.6）、新生儿败血症（调整后风险比=3.4，95%置信区间=1.1-10.8）、低血糖（调整后风险比=3.2，95%置信区间=1.1-9.3）和强直型惊厥（调整后风险比=4.5，95%置信区间=1.3-15.6）是惊厥新生儿早期死亡的统计学显著预测因素。本研究表明，惊厥新生儿的院内死亡率较高且中位死亡时间较短；并确定了早期死亡的预测因素。对有出生创伤、败血症和低血糖的新生儿进行早期检测和适当管理可能会有所帮助。
