Neonatal Hypoxic-Ischemic Encephalopathy: Single Tertiary Centre Experience

Abstract

Purpose This study aimed to determine the factors associated with Neonatal hypoxic-ischemic encephalopathy (HIE) and its neurodevelopmental outcomes. Methods A case-control study of infants delivered at King Abdulaziz Medical City, Riyadh, Saudi Arabia, was carried out from 2015 to 2019. Newborns with an admission diagnosis of HIE were identified, and controls were matched for the case. The electronic medical records were used to extract the clinical data for each case. The HIE cases were followed for 24 months to determine their neurodevelopmental outcomes. Results The sample included 60 infants diagnosed with HIE and 234 infants as controls, primarily males (56%) with mean gestational age of 38 weeks (SD 1.6). According to Sarnat staging, 36% of the HIE cases (22 patients) had stage 2 encephalopathy, while 35% of infants were at stage 3. Children with HIE were twice as likely to be born to mothers with maternal comorbidities, and more likely to have prepartum and intrapartum complications than the control group. The follow-up of neurodevelopmental outcomes at 24 months for the HIE infants indicated no delays in development of gross motor skills (76%), fine motor skills (78%), language skills (67%), and social skills (78%). Conclusion Maternal comorbidities and prepartum or intrapartum complications were more prevalent in the HIE group. HIE severity grade can be used as a prognostic, predictive tool for neurodevelopmental outcomes. Neurodevelopment follow up for at least 24 months is necessary to enhance care and rehabilitation of the patients.