The rate of intracranial hemorrhage is higher among infants delivered by vacuum extraction, forceps, or cesarean section during labor than among infants delivered spontaneously, but the rate among infants delivered by cesarean section before labor is not higher, suggesting that the common risk factor for hemorrhage is abnormal labor.

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Objective-To assess antenatal and intrapartum risk factors for seizures occurring during the birth admission.Study design-Using multivariable logistic regression analysis, we evaluated the association between maternal characteristics and birth admission seizures in a cohort of 2.3 million California children born ≥36 weeks gestation from 1998-2002 using the California Office of Statewide Planning and Development database containing birth certificates linked to infant and maternal hospital discharge abstracts.Results-The incidence of seizures during the birth admission was 0.95/1000 live births. In an adjusted analysis, infants of women who were 40 or older, were nulliparous, had diabetes mellitus, intrapartum fever or infection or who delivered ≥42 weeks had an increased risk of seizures. Infants of Hispanic and Asian mothers had a lower risk when compared with infants of white mothers.Conclusions-Several maternal antenatal and intrapartum factors increased the risk of seizures during the birth admission. Identifying and avoiding risks for neonatal seizures may lead to lower infant neurological morbidity and mortality. Keywords Population attributable riskThe estimated incidence of seizures in term newborns is 1-3.5 per 1000 live births (1-4) (5,6). Seizures in the neonate frequently reflect significant underlying brain injury such as hypoxic ischemic injury, stroke, intracranial infection or hypoglycemia (2,7). Neonates with seizures have a high incidence of mortality and adverse long-term neurological outcome (5,8).Address correspondence to: Hannah C. Glass, University of California San Francisco, Department of Neurology Box 0663, 521 Parnassus Avenue, San Francisco,, Email: Hannah.Glass@ucsf.edu. Edited by AJ and WFB The NINDS Neurological Sciences Academic Development Award (NS01692) supports HCG.The authors declare no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access MethodsWe examined a population-based cohort using a (642.41-642.42, 642.51-642.52, 642.61-642.62). Mode of delivery was categorized into four groups: routine vaginal, operative vaginal (using vacuum or forceps), daytime cesarean (during the hours 6:00-17:00) and nighttime cesarean (17:01-5:59). Potential infant confounding variables included meningitis (320-320.9, 322.9) and other infection, not meningitis (771.4,771.8-89).Our outcome of interest was defined as convulsions (780.3) or seizures in a newborn (779.0) diagnosed during the birth hospitalization. StatisticsContinuous variables were compared using a two-tailed Student's t-test. The association be...