Motor, Cognitive and Behavioural Outcomes After Neonatal …

Hortigüela MM, Martínez-Biarge M, Conejo D, Vega-Del-Val C, Arnaez J; Grupo ARAHIP. Motor, cognitive and behavioural outcomes after neonatal hypoxic-ischaemic encephalopathy. An Pediatr (Engl Ed). 2024 Feb;100(2):104-114. doi: 10.1016/j.anpede.2024.01.009. Epub 2024 Feb 7. PMID: 38331678.

Introduction
The current neurodevelopmental status of patients with neonatal hypoxic-ischaemic encephalopathy (HIE) in Spain is unknown. Recent European studies highlight a shift of severe pathology towards mild motor disorders and emotional problems. The aim of this study was to analyse neurodevelopmental outcomes in a cohort of neonates with HIE at age 3 years.

Patients and method
Multicentre observational study of neonates born at 35 or more weeks of gestation with moderate to severe HIE in 2011-2013 in 12 hospitals in a large Spanish region (91 217 m2), with the recruitment extended through 2017 in the coordinating hospital. We analysed the findings of neonatal neuroimaging and neurodevelopmental test scores at 3 years (Bayley-III, Peabody Picture Vocabulary Test and Child Behavior Checklist). The sample included 79 controls with no history of perinatal asphyxia.

Results
Sixty-three patients were recruited, of whom 5 (7.9%) were excluded due to other pathology and 14 (24%) died. Of the 44 survivors, 42 (95.5%) were evaluated. Of these 42, 10 (24%) had adverse outcomes (visual or hearing impairment, epilepsy, cerebral palsy or developmental delay). Other detected problems were minor neurological signs in 6 of the 42 (14%) and a higher incidence of emotional problems compared to controls: introversion (10.5% vs. 1.3%), anxiety (34.2% vs. 11.7%) and depression (28.9% vs. 7.8%) (P < .05). The severity of the lesions on neuroimaging was significantly higher in patients with motor impairment (P = .004) or who died or had an adverse outcome (P = .027).

Conclusion
In addition to classical sequelae, the followup of patients with neonatal HIE should include the diagnosis and treatment of minor motor disorders and social and emotional problems.

Keywords
Behavioural difficulties; Encefalopatía hipóxico isquémica; Hipotermia terapéutica; Hypoxic-ischaemic encephalopathy; Minor neurological signs; Neurodesarrollo;

Disponível Em: <https://pubmed.ncbi.nlm.nih.gov/>