Term‐born infants with a perinatal stroke frequently had seizures and were prescribed anti‐seizure medication at discharge

Aim We investigated the prevalence of seizures in term‐born infants with a perinatal stroke in Swedish neonatal wards, assessed the anti‐seizure medication prescribed and determined the accuracy of diagnostic codes. Methods This cross‐sectional study used data from the Swedish Neonatal Quality Register. The cases were infants born at ≥37 weeks in 2009–2018 and admitted to a neonatal ward in Stockholm County with a stroke diagnosis, confirmed by their medical chart. The controls were all Swedish infants born during those years. Results There were 76 infants with a confirmed perinatal stroke: 51 ischaemic and 25 haemorrhagic. Seizures were documented in 66/76 (87%) of infants with a stroke and 0.2% of the controls. Anti‐seizure medication was administered to 64/66 (97%) infants with a stroke and seizures. In 60 cases, the drugs administered were specified, with phenobarbital used in 59/60 cases (98%). More than one drug was administered to 25/60 (42%) infants and 31/60 (52%) were discharged with anti‐seizure medication. The positive predictive value for the stroke diagnostic codes was 80.5% (95% CI 76.5–84.5). Conclusion Seizures were common in infants with a perinatal stroke. More than one anti‐seizure drug was often required and many infants were on anti‐seizure medication at discharge, against Swedish recommendations.