Growth and developmental outcomes of infants with hypoxic ischemic encephalopathy

Abstract

Despite advances in obstetric care, hypoxic ischemic encephalopathy (HIE) remains a significant disease burden. We determined the national trends of HIE prevalence, therapeutic hypothermia (TH) use, mortality, and outcomes from 2012 to 2019. This study included term infants diagnosed with HIE between 2012 and 2019 from the National Health Insurance Service database. The prevalence of HIE was 2.4 per 1000 births without significant change during the period. TH was performed in approximately 6.7% of infants with HIE, and the annual variation ranged from 2.4 to 12.5%. The mortality among all term infants with HIE was 4.6%. The mortality rate among infants with HIE and TH significantly declined from 40 to 16.9% during the eight years. Infants with TH had higher mortality, increased use of inhaled nitric oxide, and more invasive ventilator use, indicating greater disease severity in the TH group. Infants with TH also showed significantly poorer outcomes, including delayed development, cerebral palsy, sensorineural hearing loss, and seizure, compared to infants without TH (p < 0.0001). With the increasing application of TH, mortality and developmental outcomes among infants with HIE have been improving in the past eight years in Korea. Further efforts to improve outcomes should be needed.

Crecimiento y desarrollo en infantes con antecedentes de encefalopatía hipóxico-isquémica

“…Si bien la HT reduce el riesgo de muerte, las secuelas del neuro desarrollo en infantes sobrevivientes con esta condición son diversas, se han reportado alteraciones motoras, cognitivas, neuropsicológicas, conductuales o del lenguaje (Chalak et al, 2021;Dzikienė et al, 2021;Estiphan et al, 2023;Groenendaal et al, 2013;Hortigüela et al, 2024;Martínez-Biarge et al, 2012;Pappas et al, 2015;Pinto et al, 2023;Simbruner et al, 2010;Sutin et al, 2023;Sweetman et al, 2022). Además, de los trastornos en la alimentación derivados de las alteraciones en la succión-deglución, reflujo gastroesofágico, disminución en la motilidad intestinal, hipertono o distonía que afectan la musculatura oro-facial, así como eventos recurrentes de atragantamiento, los cuales determinan cuadros de desnutrición, existe amplia evidencia que la desnutrición en esta etapa temprana de la vida tiene un impacto negativo en el crecimiento físico, considerado indicador relevante de mayor riesgo de alteración en el desarrollo neurológico (Alzamora et al, 2010;Fontaine et al, 2023;Georgieff et al, 2018;Jayakumar et al, 2024;Jensen et al, 2017;Martínez-Biarge et al, 2012Matonti et al, 2020;Park et al, 2023;Prado & Dewey, 2014).…”