Abstract Details

Title Seizures in Term & Preterm Neonates: A U.S. Population-based Analysis for Resource Utilization and Mortality Trends (2016-2022)

Topic Child Neurology and Developmental Neurology

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 8-006

Objective To evaluate the incidence of neonatal seizures among term and preterm infants in the United States and compare associated comorbidities, mortality, and healthcare resource utilization.

Background Neonatal seizures account for 0.1–0.5% of live births but increases to 14% of NICU neonates, with even higher rates predicted in preterm neonates. These seizures are often the first marker of acute neurological injury and are associated with significant mortality and morbidity. Despite recent advances in perinatal care and neurodiagnostics, limited contemporary, population-based studies evaluate seizure incidence, etiologies, and outcomes.

Design/Methods A retrospective cohort study was conducted using the Healthcare Cost and Utilization Project–Nationwide Inpatient Sample 2016–2022 dataset. ICD-10-CM codes were used to identify in-hospital births with seizures, excluding transfers. The cohort was stratified by gestational age and seizure status. Weighted analysis accounted for dataset stratification. Multivariable logistic and generalized linear models evaluated associations for mortality, length of stay (LOS), and hospital charges, adjusting for demographics, hospital characteristics, and perinatal comorbidities.

Results

Among 23 million in-hospital births, 10,250 (0.04%) were term neonates with seizures and 7,180 (0.03%) preterm neonates with seizures. Seizures were associated with increased mortality (term: 8.8% vs 0.06%; preterm: 30.2% vs 2.4%), prolonged LOS (term: 11 vs 2 days; preterm: 53 vs 6 days), and higher cost (term: median $103k; preterm: $414k; p < 0.001). Adjusted odds of mortality remained elevated (term: OR 1.98; preterm: OR 4.07). The most common comorbidities were hypoxic-ischemic encephalopathy in term neonates and intraventricular hemorrhage and sepsis in preterm neonates. Seizures were more frequent among Black, publicly insured, and lower-income infants.

Conclusions Neonatal seizures remain powerful markers of neurological injury, systemic illness, and healthcare strain in this nationally-representative, contemporary cohort. Preterm neonates experience disproportionate mortality, prolonged hospitalization, and higher costs, and higher hospital charges than their term counterparts, thus necessitating gestational age–specific approaches to seizure surveillance, evaluation, and management.

Authors/Disclosures
Snigdha Kosuri, MPH PRESENTER	Miss Kosuri has nothing to disclose.
Avantika Singh, MD (Medical College of Wisconsin)	Dr. Singh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell.
Jigar Patel, MD	Dr. Patel has nothing to disclose.
Susan S. Cohen, MD	Dr. Cohen has nothing to disclose.
Erwin T. Cabacungan, MD	Dr. Cabacungan has nothing to disclose.

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