Seizures in a Term Newborn

A 31-year-old gravida 7, para 4 woman delivers a male infant via vaginal delivery without the use of forceps or vacuum extraction after induction of labor at 39 weeks and 2 days of gestation. The pregnancy was complicated by tobacco use throughout gestation. The mother received routine prenatal care and her laboratory findings were negative for infections, including group B Streptococcus. Membranes ruptured 2 hours before delivery, and the amniotic fluid was meconium stained. Resuscitation is routine, and the neonate’s Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. The infant’s birthweight of 3,465 g places him in the 50th to 75th percentile for age and his length and head circumference are greater than the 90th percentile for age. He undergoes triage in the well-baby nursery where his admission physical examination findings are normal. He remains with his mother until approximately 22 hours after birth when...