Cognitive Outcomes After Neonatal Encephalopathy

ABSTRACT: Cognitive impairment is an important issue found in survivors at 18 to 24 months in all major previous trials of hypothermia treatment of hypoxic ischemic encephalopathy (HIE). The authors of this study hypothesized that infants between 18 and 22 months with a Mental Developmental Index of less than 70 would continue to have cognitive impairment and development disabilities at school age. The study aimed to report special educational services and therapies, describe the range of cognitive outcomes of moderate or severe HIE in children, and evaluate the value of various predictors of school-age cognition. Data from the National Institute for Child Health and Development Neonatal Research Network multicenter trial of whole-body hypothermia, conducted between 2000 and 2003, were used in this secondary analysis. Participants who experienced moderate and severe encephalopathy within the first 6 hours of life were treated with either hypothermia or routine neonatal intensive care. Follow-up was at 18 to 22 months and 6 to 7 years and included neurologic examinations, the Bayley Scales of Infant Development, Wechsler intelligence scales, and Neuropsychological Assessment–Developmental NEuroPSYchological Assessment (NEPSY). Cerebral palsy severity was identified using the Gross Motor Function Classification System. Of 140 surviving children, 30 were lost to follow-up. Twenty-two percent of children were found to be untestable with the NEPSY because of severe cognitive...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Obstetrics: Newborn Medicine Source Type: research

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Discussion “Neonatal encephalopathy, manifesting as altered responsiveness, seizures, apnea and abnormal muscle tone and reflexes, resulting from hypoxic-ischemic injury is termed hypoxic-ischemic encephalopathy (HIE).” Neonatal encephalopathy can be associated with other problems including stroke, hemorrhage, infection, pre-term brain injury and hypoglycemia as some examples. Sometimes more than one of these entities occurs simultaneously such as hypoglycemia and HIE. HIE can result in long-term neurological problems including motor, behavioral, and cognitive problems that can become apparent even years later....
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
CONCLUSIONS: The relatively low prevalence of disability (32%) at 18-24 months suggests that use of TH in a Level 2 nursery is feasible and possibly beneficial. More studies are needed to confirm these findings.ABBREVIATIONS: aEEG: amplitude electroencephalogram; CP: cerebral palsy; GMDS: Griffiths mental developmental scales; GQ: general quotient; HIC: high-income countries; HIE: hypoxic-ischaemic encephalopathy; LMIC: low- and middle-income countries; LTFU: loss to follow-up; NICU: neonatal intensive care unit; TH: therapeutic hypothermia; TOBY: total body hypothermia.PMID:34493152 | DOI:10.1080/20469047.2021.1967625
Source: Paediatrics and international child health - Category: Pediatrics Authors: Source Type: research
ConclusionMgSO4 is a safe drug to use in antenatal women at risk for impending preterm. Antenatal magnesium sulfate given to women in established preterm labor conferred significant neuroprotective advantage to the neonate. MgSO4 also has protective effect on the need of invasive ventilatory support in preterm infants. Given the breadth of evidence in its favor, it is time for us to start using MgSO4 in clinical practice for neuroprotective intent in all our extreme preterm births.
Source: The Journal of Obstetrics and Gynecology of India - Category: OBGYN Source Type: research
Neonatal encephalopathy (NE) is a significant complication of the peripartum period. It can lead to lifelong neurologic disabilities, including cerebral palsy, cognitive impairments, developmental delays, and epilepsy. Induced hypothermia is the first therapy, which has shown promise in improving the outcomes for neonates with moderate to severe NE following a presumed intrapartum insult.NE is also a frequent source of medical malpractice litigation. In this paper, we will review salient features of the American Tort System as it pertains to medical malpractice.
Source: Seminars in Fetal and Neonatal Medicine - Category: Perinatology & Neonatology Authors: Source Type: research
Intranasal administration of Cytoglobin modifies human umbilical cord‑derived mesenchymal stem cells and improves hypoxic‑ischemia brain damage in neonatal rats by modulating p38 MAPK signaling‑mediated apoptosis. Mol Med Rep. 2020 Aug 19;: Authors: Yang H, Tian S, Xie L, Chen Y, Ma L Abstract Neonatal hypoxic‑ischemic brain damage (HIBD) is a common clinical syndrome in newborns. Hypothermia is the only approved therapy for the clinical treatment; however, the therapeutic window of hypothermia is confined to 6 h after birth and even then,>40% of the infants either die or survive with v...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019.Recent FindingsEffective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pre...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Abstract Neonatal ischemic brain injury causes permanent motor-deficit cerebral palsy. Hypoxic-ischemic encephalopathy (HIE) is a very serious condition that can result in death and disability. In 1997, we reported that irreversible neuronal cell damage is induced by the elevation of intracellular Ca ion concentration that has occurred in sequence after excess accumulation of the excitatory neurotransmitter glutamate during ischemia. We also reported that hypothermia was effective in treating ischemic brain damage in rats by suppressing energy loss and raising intracellular Ca ion concentration. Following the 2010...
Source: Pediatric Research - Category: Pediatrics Authors: Tags: Pediatr Res Source Type: research
Publication date: Available online 30 June 2017 Source:Nanomedicine: Nanotechnology, Biology and Medicine Author(s): Christina L. Nemeth, Gabrielle T. Drummond, Manoj K. Mishra, Fan Zhang, Patrice Carr, Maxine S. Garcia, Sydney Doman, Ali Fatemi, Michael V. Johnston, Rangaramanujam M. Kannan, Sujatha Kannan, Mary Ann Wilson Perinatal hypoxic–ischemic encephalopathy (HIE) can result in neurodevelopmental disability, including cerebral palsy. The only treatment, hypothermia, provides incomplete neuroprotection. Hydroxyl polyamidoamine (PAMAM) dendrimers are being explored for targeted delivery of therapy for HIE. Unde...
Source: Nanomedicine: Nanotechnology, Biology and Medicine - Category: Nanotechnology Source Type: research
Conclusions/Significance: In this nonhuman primate HIE model, animals treated with TH + Epo had less brain pathology noted on TBSS and IHC staining, which supports the long-term safety of TH + Epo in the setting of HIE. Animals that developed CP showed white-matter changes noted on TBSS, subtle histopathological changes in both the white and gray matter, and brainstem injury that correlated with CP severity. This HIE model may lend itself to further study of the relationship between brainstem injury and CP.Dev Neurosci
Source: Developmental Neuroscience - Category: Neuroscience Source Type: research
Neonatal encephalopathy (NE) is a major cause of neonatal mortality and morbidity. Therapeutic hypothermia (TH) is standard treatment for newborns at 36 weeks of gestation or greater with intrapartum hypoxia-related NE. Term and late preterm infants with moderate to severe encephalopathy show improved survival and neurodevelopmental outcomes at 18 months of age after TH. TH can increase survival without increasing major disability, rates of an IQ less than 70, or cerebral palsy. Neonates with severe NE remain at risk of death or severe neurodevelopmental impairment. This review discusses the evidence support...
Source: Clinics in Perinatology - Category: Perinatology & Neonatology Authors: Source Type: research
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