Seizures common in congenital heart disease

Infants appear to have a more than fivefold greater odds of experiencing seizures in the presence of congenital heart disease (CHD), according to a study.

Researchers used data from the US National Inpatient Sample Database. Infants who were born prematurely (<34 weeks) and those with central nervous system or genetic disorders were excluded.

A total of 19,089,414 infants (42.4 percent female, 45.8 percent White) met the inclusion criteria, of which 417,053 (2.2 percent) had CHD. In the CHD group, 302,714 infants (72.6 percent) had shunt lesions, 45,411 (10.9 percent) had cyanotic CHD, 42,462 (10.2 percent) had left‐sided CHD, and 26,466 (6.3 percent) had single ventricle lesions.

Seizures were documented in 47,501 infants (0.25 percent) overall, with the number being higher in the CHD group than in the control group without CHD (1.8 percent vs 0.21 percent; adjusted odds ratio [aOR], 5.7, 95 percent confidence interval [CI], 5.5–5.8; p<0.001).

Across the CHD subgroups, seizures were least common among infants with cyanotic CHDs and most common among those with single ventricle physiology (3.2 percent). In the subgroups of infants with shunt lesions or left-sided CHD, seizures were reported in 1.8 percent and 1.9 percent, respectively.

Risk factors for seizures in infants with CHD included male sex, maternal hypertension, sepsis, acute kidney injury, stroke, and extracorporeal membrane oxygenation support.

In the CHD group, seizure was associated with a more than threefold greater odds of mortality (8.5 percent vs 1.1 percent; aOR, 3.6, 95 percent CI, 3.3–4.0; p<0.001).