Long-Term Outcomes of Perinatal Hypoxia and Asphyxia at an Early School Age

Abstract

Background and Objectives: Late long-term outcomes of perinatal asphyxia (PA) in school-age are often unclear. To assess long-term outcomes at an early school age in children who had experienced perinatal hypoxia or asphyxia, where therapeutic hypothermia was not applied. Materials and Methods: The case group children were 8–9-year-old children (n = 32) who were born at full term and experienced hypoxia or asphyxia at birth, where therapeutic hypothermia (TH) was not applied. The control group consisted of 8–9-year-old children (n = 16) born without hypoxia. A structured neurological examination was performed at an early school age. The neuromotor function was assessed using the Gross Motor Function Classification System (GMFCS). Health-related quality-of-life was assessed using the Health Utilities Index (HUI) questionnaire. Intellectual abilities were assessed using the Wechsler Intelligence Scale for Children (WISC). Results: The case group, compared with controls, had significantly (p = 0.002) lower mean [SD] full-scale IQ (87(16.86) vs. 107(12.15)), verbal-scale IQ (89(17.45) vs. 105(11.55)), verbal comprehension index (89(17.36) vs. 105(10.74)), working memory index (89(15.68) vs. 104(11.84)), performance IQ (87(16.51) vs. 108(15.48)) and perceptual organization index (85(15.71) vs. 105 (15.93)). We did not find any significant differences in the incidence of disorders of neurological examination, movement abilities and health-related quality of life at an early school age between the case and the control group children. Conclusion: In children who experienced perinatal asphyxia but did not have cerebral paralysis (CP), where therapeutic hypothermia was not applied, cognitive assessment scores at an early school age were significantly lower compared to those in the group of healthy children, and were at a low average level.

Time to death and its predictors among asphyxiated neonates admitted to Jimma University Medical Center, Ethiopia: a retrospective cohort study

“…Moreover, at 18-22 months of age, epilepsy, blindness, severe hearing impairment, and disabling cerebral palsy were found in 16%, 14%, 6%, and 30% of asphyxiated neonates, respectively (22)(23)(24). Furthermore, these neonates were found to have lower academic performance at 8-9 years of age (25).…”

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).…”

Hypothermia after Perinatal Asphyxia Does Not Affect Genes Responsible for Amyloid Production in Neonatal Peripheral Lymphocytes

“…According to existing data, 20 out of 1000 live births require resuscitation, resulting in clinical and biochemical symptoms of perinatal asphyxia [ 1 , 2 ]. Currently, perinatal asphyxia affects approximately 4 million newborns annually worldwide [ 3 ].…”

“…About 15–25% of these newborns die in the neonatal period, up to 25% of survivors develop neurological deficits, and 10–30% have retarded psychomotor development [ 4 , 5 ]. Studies analyzing the long-term consequences in preschool children after perinatal asphyxia have shown that cerebral palsy develops in 5.5–52% [ 6 , 7 , 8 , 9 ], severe disability in 11–19% [ 6 ], various motor impairments in 1.3–40% [ 2 , 8 , 9 , 10 ], hearing loss in 2–20% [ 6 , 9 , 10 ], vision defects in 1.8–40% [ 6 , 9 , 11 ], speech disorders in 4.2–21% [ 6 , 7 , 8 ], epilepsy in 13%, and cognitive impairment in 31% [ 1 , 2 , 12 ].…”