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 Assessmentā€“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 and...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Obstetrics: Newborn Medicine Source Type: research