Neurodevelopmental Follow Up After Therapeutic Hypothermia for Perinatal Asphyxia

Abstract

Introduction:Neuroprotective benefit of therapeutic hypothermia in term newborns with hypoxic-ischemic encephalopathy (HIE) was assessed by analyzing survival and neurodevelopmental outcome of neonates subjected to this procedure.Material and methods:Newborns with gestational age > 36 weeks and < 6 hours of age with moderate to severe asphyxial encephalopathy underwent cooling protocol at a temperature of 33.5 °C for 72 hours and rewarming period of 6 hours. Outcome measures assessed were death and neurodevelopmental characteristics, which were compared at the different age using ASQ-3. Twenty-five children were assessed at age 3-6, 12-18 and 24-36 months. Median gestational age was 40 weeks, birth weight 3470 g, Apgar score 2/4 and pH on admission to the hospital 7.02. Four (16%) children died.Results:At the first assessment developmental categories of communication were normal in 78.9%, problem solving in 63.2%, personal-social in 68.4%, gross motor in 68.4%, and fine motor in 42.1% with a high need of retesting in this area. Second assessment was done in 17 patients: developmental categories of communication normal in 58.8%, problem solving in 70.6%, personal-social in 64.7%, gross motor in 64.7%, and fine motor in 35.3%. Third evaluation was done in 14 patients: developmental categories of communication were normal in 64.3%, problem solving in 71.4%, personal-social in 57.1%, gross motor in 64.3%, and fine motor in 42.9%.Conclusion:There was no correlation between baseline parameters and outcome. Results of the study are showing that therapeutic hypothermia in term newborns can provide better survival and less neurologic sequels in HIE patients.

Clinical presentations and patterns of neuro-developmental disorders in a health facility in Ghana: implications for the health and educational sectors

“…Similarly demonstrated high comorbidity of autism with intellectual disability and seizures in the Democratic Republic of Congo in a clinical setting [25]. The significant association found between birth asphyxia and delivery complications, the type of delivery, gestational age and cerebral palsy is consistent with many studies that indicate that 25 -60% of babies that suffer asphyxia at birth may suffer cerebral palsy and other neurological problems including intellectual disability and seizures [37,38]. It is, therefore, possible that the traumatic deliveries which carry the potential risk of brain hypoxia to the child may have resulted in some asphyxia with resultant NDD among the cohort children in this study.…”

Post-Treatment with Amorfrutin B Evokes PPARγ-Mediated Neuroprotection against Hypoxia and Ischemia

“…Each year, one million children die due to hypoxia and neonatal oxygen deprivation, which leads to permanent brain damage and disability such as hypoxic-ischemic encephalopathy [ 5 ]. Oxygen therapy and moderate hypothermia occurring up to 6 h after the hypoxic episode are the gold standard treatment for neonatal asphyxia [ 6 ].…”

Clinical significance of electroencephalography power spectrum density and functional connection analysis in neonates with hypoxic‐ischemic encephalopathy

“…Severe HIE usually has a history of severe perinatal asphyxia and may lead to different neurological disabilities. The prognosis of children with mild HIE is relatively good, and almost all children have good outcomes (Zubcevic et al., 2015). About one‐third of children with moderate HIE have a delay in all milestone developmental stages (Adhikari & Rao, 2017), but there are also many cases with good prognosis.…”