Synergistic Clinico-Radiological Assessment of Term Newborns Afflicted by Birth Asphyxia in a Tertiary Medical Center: A Prospective Observational Study

Abstract

Background and objectives Hypoxic-ischemic encephalopathy (HIE) remains a critical concern in newborns, with therapeutic hypothermia (TH) serving as a key treatment strategy. However, assessing long-term outcomes requires a comprehensive approach, as children may develop neuropsychological and learning challenges even in the absence of noticeable motor impairments. This study aims to explore the correlation between electroencephalography (EEG) and neuroimaging findings with the clinical severity of HIE. Materials and methods This prospective observational study included a sample of 110 term neonates with birth asphyxia admitted to a medical college-affiliated hospital in Telangana, India. Data were collected on a predesigned Case Record Form by a single investigator through direct interviews with parents, caregivers, and other relevant individuals. Results Among the 110 neonates analyzed, most fell into HIE Grade II (49.1%), delivered predominantly via normal vaginal delivery (61.8%). Common risk factors included prolonged labor (57.3%) and meconium-stained amniotic fluid (42.7%). Serum parameters revealed variations, with significant associations between sodium, potassium, blood urea, blood culture, EEG, and magnetic resonance imaging (MRI) findings and HIE staging. Abnormal EEG (36.4%) and MRI (63.6%) findings correlated significantly with HIE severity. Conclusions The study provides valuable insights into clinico-radiological correlations in term newborns with birth asphyxia, highlighting the diagnostic value of EEG and neuroimaging modalities. Serum parameters and imaging findings showed significant associations with HIE severity, emphasizing the importance of comprehensive assessment in predicting neonatal outcomes. EEG and MRI demonstrated high sensitivity in predicting abnormal neurological conditions at discharge, suggesting their utility in prognostication.