Predictors of recurrent febrile seizure in children aged from 6 months to 5 years: A cross-sectional study

Objective: To study the clinical profiles of children with febrile seizures, comparing those with single episodes to recurrent cases, and identify predictors of recurrence. In addition, to develop a scoring system to predict recurrence after the first febrile seizure, and identify modifiable risk factors to mitigate recurrence risks. Methods: This cross-sectional study included children aged 6 months to 5 years with typical febrile seizures, seen as inpatients or outpatients of the Department of Pediatrics at a tertiary care teaching hospital. Data were collected via parent interviews, physical exams, and laboratory tests. The questionnaire covered demographics, antenatal, natal, and postnatal events, seizure history, family history, immunization, daycare attendance, and fever management. Clinical evaluations ruled out central nervous system infections and fever causes were diagnosed per ICD-10 at discharge. Laboratory tests assessed anemia, dyselectrolytemia, and hypoglycemia. Data were analyzed in SPSS Version 25 using descriptive statistics, t-tests, Chi-square tests, and odds ratios with 95% confidence intervals (CI), with significance set at P<0.05. Results: 451 children were included in this study. Low birth weight (OR=2.60, 95% CI=1.12-6.33, P=0.026), age at first episode <12 months (OR=0.28, 95% CI=0.16-0.48, P>0.001), family history of febrile seizure (OR=5.21, 95% CI=2.92-9.28, P>0.001), no intermittent prophylaxis (OR=15.25, 95% CI=7.05-32.90, P>0.001), treatment for fever (OR=0.26, 95% CI=0.13-0.51) and low socioeconomic status (OR=5.87, 95% CI=3.32-10.38) were significantly associated with recurrent febrile seizures. Conclusions: Low birth weight, age at first episode ⩽12 months, family history of febrile seizure, no intermittent prophylaxis, inadequate treatment for fever and low socioeconomic status were significant risk factors for having recurrent febrile seizures in children aged from 6 months to 5 years.