Clinical and Biochemical Predictors of Hypocalcemic Seizures in Infancy: Association with Age, Gender, Breastfeeding, and Growth Parameters

Background: Early recognition of clinical and biochemical predictors may help identify high-risk infants and allow timely correction of calcium imbalance. The objective is to evaluate the clinical and biochemical predictors of hypocalcemic seizures in infancy, with emphasis on age, gender, breastfeeding status, growth parameters, and corrected calcium levels. Material and Methods: This prospective observational study included 100 infants aged 1 month to 2 years presenting with seizures to the Department of Pediatrics, Kodagu Institute of Medical Sciences, Madikeri. Infants with central nervous system infection, congenital brain malformations, and maternal drug or supplement exposure affecting bone mineral metabolism were excluded. Corrected calcium was calculated, and hypocalcemia was defined as corrected serum calcium <8 mg/dL. Results: Among 100 infants, 27 (27.0%) had hypocalcemic seizures and 73 (73.0%) had non-hypocalcemic seizures. Hypocalcemia was significantly more common in infants aged <6 months, affecting 20 of 49 infants (40.8%), compared with 4 of 25 (16.0%) infants aged 6 months to 1 year and 3 of 26 (11.5%) infants aged 1–2 years (p = 0.009). Female infants showed a significantly higher frequency of hypocalcemia than males, 24 of 67 (35.8%) versus 3 of 33 (9.1%) (p = 0.005). All 27 infants with hypocalcemic seizures were breastfed. Length percentile was also significantly associated with hypocalcemia, with higher frequency among infants below the 50th percentile (p = 0.002). Conclusion: Hypocalcemic seizures in infancy were significantly associated with age <6 months, female gender, breastfeeding status, lower length percentile, and reduced corrected calcium levels.

Keywords: Hypocalcemic seizures; Infancy; Corrected serum calcium; Breastfeeding; Clinical predictors; Pediatric seizures.