Communal Poverty Is a Significant Risk Factor for Neonatal Seizures

Abstract

Introduction Neonatal seizures (NS) are a severe condition with significant mortality and long-term morbidity. This study aims to identify risk factors for NS in a racially or ethnically diverse population in Israel.

Methods This is a case–control study. The cases were all newborns born between 2001 and 2019 at Emek Medical Center in Israel and admitted with NS. Two healthy controls born in the same period were matched for each case. Demographic, maternal, and neonatal variables were abstracted from the electronic medical files.

Results A total of 139 cases were matched with 278 controls. Residing in a town with lower socioeconomic status (SES), primiparity and abnormal prenatal ultrasound were significantly associated with NS. Prematurity, assisted delivery, a lower birthweight, being small for gestational age, and lower Apgar score were also associated with NS. In two different multivariable regression models, lower SES (odds ratio [OR] = 4.07) and Arab race/ethnicity (OR = 2.66) were risk factors for NS. Other significant risk factors in the multivariable regression models included an assisted mode of delivery (OR = 2.33), prematurity (OR = 2.27), and a 5-minute Apgar score below 7 (OR = 54.1).

Discussion Communal poverty, as reflected by lower SES of towns of residence, was found to be a stronger risk factor than race or ethnicity, for NS. More studies should focus on social class, as a risk factor for maternal and neonatal adverse outcomes. As SES is a modifiable variable every effort should be invested in fighting communal poverty and improving the SES of impoverished towns and population.

Keywords

neonatal seizures - socioeconomic status - racial disparities - poverty

Ethical Approval

The research was approved by the Ethics Committee at Emek Medical Center, Afula, Israel.

Authors Contributions

O.T. and L.L. conceptualized and designed the study, drafted the manuscript, and reviewed and revised the manuscript. K.T.H.Y. and A.E. applied for the institutional review board, collected data, and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publikationsverlauf

Eingereicht: 24. August 2022

Angenommen: 26. April 2023

Artikel online veröffentlicht:
15. Juni 2023

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