Impact of Nutritional Status and Vitamin D Levels in Children with Febrile Seizure from a Suburban Tertiary Hospital in Tamil Nadu, India

Abstract

Introduction: Febrile seizure is one of the most common paediatric emergencies encountered in a paediatric practice. There have been studies done with regards to iron deficiency anaemia and family history and chances of a child developing febrile seizure. Many studies state that vitamin D has a role in development of brain and seizure activity. Aim: To find the association between Vitamin D levels and febrile seizures in children and assessing the nutritional status of children with febrile seizures. Materials and Methods: Fifty consecutive children (developmentally normal), between ages of 9-60 months, presenting with febrile seizures to the Paediatric Department, from February 2019 to January 2020, were enrolled. Antenatal history regarding birth order, maternal weight gain, antenatal check-ups, antenatal supplements and medical problems in mother if any, were noted. Birth history, birth weight, breast feeding, complimentary feeding and present diet history were noted. The height and weight were documented. Skin colour was noted based on Fitzpatrick scale. Vitamin D levels were classified as deficient if blood levels were <10 IU; insufficient if between 10-30 IU and sufficient, if the levels were >30 IU. Collected data were analysed and compared using Sigma Plot 13 and Chi-square test was done and a p-value <0.05 was considered as statistically significant. Results: Vitamin D insufficiency was prevalent in 68% of children. The dark skin, reduced time spent outdoors, clothing habits and diet and antenatal factors contribute to this vitamin D insufficiency. A 58% of children had Height for Age Z (HAZ) score less than -1SD and 62% of children had Weight for Age Z (WAZ) score less than -1SD. On correlating the Complete Blood Count (CBC) values with iron deficiency, it was found that 56% of children with febrile seizure had anaemia based on Red-cell Distribution Width (RDW) value >14.5. Febrile seizure was less common in summer (16%). Conclusion: A 68% of children had vitamin D insufficiency. A 56% of children had low iron based on RDW. The nutritional status of children was poor as assessed by HAZ and WAZ scores.