Early EEG Grade and Outcome at 5 Years After Mild Neonatal Hypoxic Ischemic Encephalopathy
- 1 October 2016
- journal article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 138 (4), e20160659
- https://doi.org/10.1542/peds.2016-0659
Abstract
OBJECTIVE: More than half of all infants with neonatal hypoxic ischemic encephalopathy (HIE) are graded as mild and do not meet current criteria for therapeutic hypothermia. These infants are often not enrolled in follow-up, and hence our knowledge of their long-term outcome is sparse. We wished to compare 5-year outcomes in a group of infants with mild, moderate, and severe HIE, graded with both early EEG and clinical assessment, none of whom were treated with therapeutic hypothermia. METHODS: Term infants with HIE and a healthy comparison group were recruited at birth. Both groups had early continuous EEG recordings. Cognitive and motor outcome was assessed at 5 years. RESULTS: Outcome was available in 53 infants with HIE and 30 infants in the comparison group at 5 years. Infants with mild HIE at birth (n = 22) had significantly lower full-scale IQ, verbal IQ, and performance IQ than comparison infants (n = 30) at 5 years (P = .001, .001, and 0.004, respectively). No difference in cognitive measures was seen between infants with mild and moderate grades HIE. Intact survival at 5 years varied across EEG grade HIE at 6 hours after birth; 75% in mild, 46% in moderate, 43% in major abnormalities, and 0% with inactive EEGs, compared with 97% in the comparison group. CONCLUSIONS: Survivors of mild HIE, graded clinically or by early EEG, have higher rates of disability than their peers and have cognitive outcomes similar to that of children with moderate encephalopathy in an uncooled HIE cohort.This publication has 27 references indexed in Scilit:
- Short-Term Outcomes of Newborns with Perinatal Acidemia Who are Not Eligible for Systemic Hypothermia TherapyThe Journal of Pediatrics, 2013
- Childhood Outcomes after Hypothermia for Neonatal EncephalopathyThe New England Journal of Medicine, 2012
- Serial MRI and Neurodevelopmental Outcome in 9- to 10-Year-Old Children with Neonatal EncephalopathyThe Journal of Pediatrics, 2010
- Early EEG Findings in Hypoxic-Ischemic Encephalopathy Predict Outcomes at 2 YearsPEDIATRICS, 2009
- Prevalence of autism-spectrum conditions: UK school-based population studyThe British Journal of Psychiatry, 2009
- Brain and cognitive‐behavioural development after asphyxia at term birthDevelopmental Science, 2006
- Autism following a history of newborn encephalopathy: more than a coincidence?Developmental Medicine and Child Neurology, 2006
- Neuropsychological and educational problems at school age associated with neonatal encephalopathyArchives of Disease in Childhood: Fetal & Neonatal, 2005
- School performance of survivors of neonatal encephalopathy associated with birth asphyxia at termThe Journal of Pediatrics, 1989
- The incidence and severity of post-asphyxial encephalopathy in full-term infantsEarly Human Development, 1985