Outcomes in children after mild neonatal hypoxic ischaemic encephalopathy: A population‐based cohort study

Abstract

ObjectiveTo investigate whether mild neonatal hypoxic ischaemic encephalopathy (HIE) in term born infants is associated with cerebral palsy, epilepsy, mental retardation and death up to 6 years of age.DesignPopulation‐based cohort study.SettingSweden, 2009–2015.PopulationLive term born infants without congenital malformations or chromosomal abnormalities (n = 505 075).MethodsBirth and health data were retrieved from Swedish national health and quality registers. Mild HIE was identified by diagnosis in either the Swedish Medical Birth Register or the Swedish Neonatal Quality Register. Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).Main outcome measuresA composite of the outcomes cerebral palsy, epilepsy, mental retardation and death up to 6 years of age.ResultsMedian follow‐up time was 3.3 years after birth. Of 414 infants diagnosed with mild HIE, 17 were classified according to the composite outcome and incidence rates were 12.6 and 2.9 per 1000 child‐years in infants with and without HIE respectively. Infants with mild HIE was four times as likely to be diagnosed with the composite outcome (HR 4.42, 95% CI 2.75–7.12) compared with infants without HIE. When analysed separately, associations were found with cerebral palsy (HR 21.50, 95% CI 9.59–48.19) and death (HR 19.10, 95% CI 7.90–46.21). HRs remained essentially unchanged after adjustment for covariates.ConclusionsMild neonatal HIE was associated with neurological morbidity and mortality in childhood. Challenges include identifying infants who may develop morbidity and how to prevent adverse outcomes.

The association between plasma IgG N-glycosylation and neonatal hypoxic–ischemic encephalopathy: a case-control study

“…Neonatal hypoxic–ischemic encephalopathy (HIE) is characterized by severe intrauterine hypoxia and abnormalities in cerebral blood flow, which can lead to extensive apoptosis of neonatal brain cells and ultimately to death ( Torn et al, 2023 ). HIE is reported to put 15 per 10,000 live births at risk in high-income countries ( Stoke et al, 2023 ).…”

Current status and controversies in the treatment of neonatal hypoxic-ischemic encephalopathy: A review

“…Approximately 25% to 30% of these children with HIE may have different types of long-term neurodevelopmental sequelae, such as cerebral palsy, learning disabilities, and seizures. [ 2 ] This is one of the major causes of neonatal death and disability and imposes a great burden on families and society. [ 3 , 4 ] To date, due to the complex mechanism of brain injury, no effective treatment has been developed that can completely protect the nerves.…”

Identification of Metabolomic Signatures for Ischemic Hypoxic Encephalopathy Using a Neonatal Rat Model

“…The incidence of HIE is estimated to be 2-6 per 1000 live births [2]. HIE is responsible for 6-9% of all neonatal deaths and 21-23% of deaths in full-term infants, while 25% develop severe neurological impairments such as cerebral palsy, seizures, intellectual disability, cognitive impairment, and epilepsy [3][4][5]. These conditions, which are often irreversible or difficult to treat, present significant challenges for those affected and their families.…”