Seizures in Infants With Congenital Heart Disease: A National Cohort Study

Background Infants with congenital heart disease (CHD) may have an increased risk of seizures. Methods We analyzed the US National Inpatient Sample Database (2016–2020). We included infants with CHD who developed seizures. We excluded premature infants <34 weeks and infants with central nervous system or genetic disorders. CHD was classified into shunt, cyanotic, left‐sided, or single ventricle lesions. We compared demographics, clinical characteristics, and outcomes between CHD infants with versus without seizures. Results Infants in the weighted sample (19 089 414) met our inclusion criteria. Of that group, 42.4% of patients were female and 45.8% were White. There were 417 053 (2.2%) patients identified with CHD, and 47 501 (0.25%) patients had at least 1 episode of seizure. Seizures occurred in 1.8% of infants with any CHD versus 0.21% of infants with no CHD (adjusted odds ratio, 5.7 [95% CI, 5.5–5.8]; P <0.001). Cyanotic CHDs were associated with the lowest incidence of seizure (1.2%) compared with shunt lesions (1.8%), left‐sided CHD (1.9%), or single ventricle physiology (3.2%). Factors associated with seizure in patients with CHD included male sex, maternal hypertension, sepsis, acute kidney injury, stroke, and extracorporeal membrane oxygenation support. Mortality was higher in infants with CHD who developed seizures (8.5% versus 1.1%, adjusted odds ratio 3.6 [95% CI, 3.3–4.0], P <0.001). Conclusions Infants with CHD have higher odds of experiencing seizure. Cyanotic CHD had the lowest incidence of seizure, while patients with single ventricle experienced the highest risk. Having seizures was associated with longer hospital stay and higher odds of mortality. This information may help in counseling families about the neurologic outcomes of infants with CHD.