Evaluation of Risk Factors Associated with First Febrile Seizure: A Hospital Based Case-Control Study

Abstract

Introduction: Febrile seizures (FS) are the most prevalent type of seizures seen in paediatric practice, yet the underlying causes remain poorly understood. Objective: This study aimed to identify risk factors associated with the first febrile seizure in children aged 6 months to 5 years. Methods: This hospital-based case-control study was conducted from January to December 2024 at the Paediatrics Department of Jalalabad Ragib-Rabeya Medical College Hospital in Sylhet including 200 children aged 6 months to 5 years, with 100 cases admitted for their first febrile seizure and 100 controls admitted for fever without a history of seizures. Data were collected using a pre-designed semi-structured questionnaire and statistical analyses, including the Chi-square test, Student’s t-test and odds ratio calculations were performed to compare risk factors between the two groups. Results: The mean age of children in the case vs control group was insignificant (17.17±8.22 vs 18.89±14.83 months; p=0.3116). However, boys exhibited a significantly higher risk of developing FS, with the odds of boys experiencing FS being twice that of girls (95% CI=1.1578 to 3.6980, p=0.0141). A family history of febrile seizures was notably linked to the occurrence of first febrile seizure, with eight times greater odds for affected children (95% CI=3.355 to 21.209, p<0.0001). There was no significant correlation identified between a family history of epilepsy and the first febrile seizure. Children who were exclusively breastfed had a lower susceptibility to febrile seizures (OR=0.409, 95% CI=0.1924 to 0.8090, p=0.0202). Antenatal and perinatal complications were significantly higher in the case group than the control group (p<0.05). The mean admission temperature for cases was significantly higher at 100.92±1.540F compared to 100.28±1.460F in controls (p=0.0029). Upper respiratory tract infections (URTI) emerged as the most common trigger for febrile seizures (p< 0.001) and serum sodium levels were significantly lower while serum calcium and random blood sugar levels were significantly higher in the case group (p<0.05). Conclusion: Male gender, positive family history of febrile seizures, inadequate exclusive breastfeeding, elevated body temperature, antenatal and perinatal complications, upper respiratory tract infections as well as abnormal serum sodium, calcium, and blood sugar levels were significant risk factors for the first episode of febrile seizure. Addressing and mitigating these risk factors could significantly reduce the incidence of febrile seizures in children.

J Rang Med Col. 2025 Sep;10(2): 72-78