Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 +/- 16 vs. 105 +/- 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 +/- 13 vs. 93 +/- 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 +/- 13 vs. 96 +/- 20, p = 0.527; Psychomotor Developmental Index 105 +/- 11 vs. 105 +/- 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited.

Automated summary

Therapeutic hypothermia is beneficial for neuroprotection in term newborns with perinatal asphyxia, but its effects on preterm infants remain unclear. This pilot study compared the long-term outcomes of late preterm asphyctic infants with and without therapeutic hypothermia to term infants. The study found that preterm infants had better mental outcomes with therapeutic hypothermia, highlighting the importance of further research in this area.