Journal
ACTA PAEDIATRICA
Volume 105, Issue 7, Pages 806-815Publisher
WILEY
DOI: 10.1111/apa.13392
Keywords
Middle-income country; Neonatal encephalopathy; Outcome; Predictors; Therapeutic hypothermia
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Funding
- Stellenbosch University Research Travel Grant
- Medical Research Council [MC_U120088465] Funding Source: researchfish
- MRC [MC_U120088465] Funding Source: UKRI
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AimThis South African study documented the survival and neurodevelopmental outcomes of infants with hypoxic-ischaemic encephalopathy (HIE) after introducing cooling to a neonatal intensive care unit and identified early markers for neurodevelopmental outcome. MethodsWe retrospectively reviewed infants that received cooling according to the Total Body Hypothermia trial protocol from 2008 to 2011. Infants were screened with the Bayley Scales of Infant and Toddler Development, Third Edition, at one year of age and underwent neurological and hearing assessments. ResultsData on 99 infants with HIE showed that 45% of cases were moderate, 23% severe and 32% mild. An abnormal amplitude integrated electro-encephalogram (aEEG) background was documented in 45 cases within 24 hours. Magnetic resonance imaging (MRI) scans were consistent with HIE in all but one case. We reviewed 50 traceable survivors at one year. Development was significantly impaired in nine and 41 were normal or mildly impaired. A severely abnormal aEEG background, severe HIE and an abnormal MRI were associated with death and severe impairment. A good suck, mild HIE, primiparity and normal MRI were associated with good outcomes. ConclusionMost infants with HIE survived without major impairment. Previously described predictors of neurodevelopmental outcome were good surrogate markers in this population.
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