Clinical Characteristics and Risk Factors of Neonatal Hypoxic-Ischaemic Encephalopathy and Its Associated Neurodevelopmental Outcomes During the First Two Years of Life: A Retrospective Study in Saudi Arabia

Abstract

Objective This study aimed to determine the clinical characteristics and factors associated with neonatal hypoxic-ischaemic encephalopathy (HIE) and its neurodevelopmental outcomes. Methods We conducted retrospective case-control research to investigate the clinical and labour-related risk factors for HIE. In addition, a single-centre cohort study was conducted on infants with HIE to describe their neurodevelopment from birth to 24 months. For this investigation, cases with a diagnosis of HIE who were born at King Abdullah Children’s Specialist Hospital (KASCH), Riyadh, Saudi Arabia, between 2015 and 2019 were identified and matched with controls from the same facility (1:4). Each case’s clinical information was extracted using electronic medical records. In addition, 24-month follow-up HIE cases were included in a cohort study to describe their neurodevelopmental outcomes. Results The sample includes 60 infants diagnosed with HIE and 234 infants serving as controls, with a mean gestational age of 38.8 weeks (SD 1.6) and a predominance of males (56.4%). Around one-third of the HIE cases (36.6%) had moderate HIE (stage 2), whereas 35.1% of infants had severe HIE (stage 3), according to Sarnat staging. Compared to the control group, children with HIE were twice as likely to be born to mothers with maternal comorbidities and more likely to have prepartum and intrapartum complications. A 24-month follow-up of neurodevelopmental outcomes for HIE babies revealed that approximately 24% exhibited delays in gross motor skill development, 22% in fine motor skill development, 33% in language skill development, and 22% in social skill development. Conclusion In the HIE group, maternal comorbidities and prepartum or intrapartum complications were more common. The severity grade of HIE can be used to predict neurodevelopmental consequences. Enhancing patient care and rehabilitation requires a minimum of 24 months of neurodevelopmental follow-up.

Prevalence of Neonatal Hypoxia in District Buner, Pakistan

“…It is defined as a neurological syndrome characterized by impaired respiratory function, diminished reflexes, low muscle tone, a reduced heart rate, and seizures in newborns following birth. HIE results from a combination of reduced oxygen delivery (hypoxia) and diminished blood flow (ischemia) to the brain (1)(2)(3). This condition is categorized into mild, moderate, and severe forms, reflecting its clinical severity (4).…”

Hypoxic-Ischemic Encephalopathy Based on clinical biomarkers and associated risk factors in Neonates from Southern Ethiopian Public Hospitals: A Case Control Study

“…Hypoxic-ischemic encephalopathy (HIE) is a serious condition that affects newborns who experience oxygen deprivation and reduced blood flow to the brain which can cause brain damage, seizures, developmental delays, and cerebral palsy [20,21]. However, the risk factors and biomarkers associated with HIE in neonates from southern Ethiopian public hospitals are not well understood.…”