Neuropsychological and educational problems at school age associated with neonatal encephalopathy

Abstract

Background: Adverse cognitive and educational outcomes are often ascribed to perinatal hypoxia without good evidence. Objective: To investigate neurocognitive and behavioural outcomes after neonatal encephalopathy. Methods: Sixty five children with neonatal encephalopathy, identified using the Trent Neonatal Survey database for 1992–1994, were followed up at the age of 7 years. They were examined at school, with a classmate for those in mainstream school, by a paediatrician and a psychologist. Neonatal encephalopathy was graded as moderate or severe using published definitions. Findings: Fifteen children had major disability, all with cerebral palsy; eight were in special school with severe cognitive impairment (IQInterpretation: After neonatal encephalopathy, subtle cognitive impairments are found in the absence of neuromotor impairment. Subtle impairments are found more commonly after a more severe clinical course. Studies of brain protection strategies require long term follow up to study effects on cognitive outcome.