4.2 Article

Prediction of outcome in asphyxiated newborns treated with hypothermia: Is a MRI scoring system described before the cooling era still useful?

Journal

EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
Volume 22, Issue 3, Pages 387-395

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ejpn.2018.01.017

Keywords

Brain; Birth asphyxia; Cerebral palsy; Epilepsy; Global developmental delay; Hypothermia; Magnetic resonance imaging; Neonatal encephalopathy; Neurodevelopment; Newborn

Funding

  1. FRSQ
  2. New Investigator Research Grant from the SickKids Foundation
  3. CIHR Institute of Human Development, Child and Youth Health (IHDCYH)

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Aim: To determine whether an MRI scoring system, which was validated in the pre-cooling era, can still predict the neurodevelopmental outcome of asphyxiated newborns treated with hypothermia at 2 years of age. Patients and method: We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia. An MRI scoring system, which was validated in the pre-cooling era, was used to grade the severity of brain injury on the neonatal brain MRI. Their neurodevelopment was assessed around 2 years of age; adverse outcome included cerebral palsy, global developmental delay, and/or epilepsy. Results: One hundred and sixty-nine newborns were included. Among the 131 newborns who survived and had a brain MRI during the neonatal period, 92% were evaluated around 2 years of age or later. Of these newborns, 37% displayed brain injury, and 23% developed an adverse outcome. Asphyxiated newborns treated with hypothermia who had an adverse outcome had a significantly higher MRI score (p < 0.001) compared to those without an adverse outcome. Conclusion: An MRI scoring system that was validated before the cooling era is still able to reliably differentiate which of the asphyxiated newborns treated with hypothermia were more prone to develop an adverse outcome around 2 years of age. (C) 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

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