Early instrumental predictors of long term neurodevelopmental impairment in newborns with perinatal asphyxia treated with therapeutic hypothermia
1Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
2 Division of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria “Maggiore della Carità”, Novara, Italy
3 Division of Child Neurology and Psychiatry, Azienda Ospedaliero-Universitaria “Maggiore della Carità”, Novara, Italy
DOI: 10.22514/SV141.042018.14 Vol.14,Issue 1,March 2018 pp.81-85
Published: 27 March 2018
Background. Hypoxic-ischemic encepha-lopathy (HIE) is a leading cause of dis-ability in full-term newborns. Long-term consequences of HIE, even when treated by hypothermia, are not easily predictable. Aims. To assess the potential role of elec-troencephalography and neuroimaging parameters as early predictors of neurode-velopmental outcome in HIE newborns treated with hypothermia.
Methods. We retrospectively evaluated 13 HIE patients treated with hypothermia in January 2012-September 2014. We re-viewed their amplitude-integrated electro-encephalography (a-EEG) at 6, 12 and 24 hours (h), cranial ultrasonography (US) at 12, 72 h and >7 days of life (DOL) and brain magnetic resonance (MRI) performed at 7-28 DOL, according to validated scores. aEEG, US and MRI patterns were correlat-ed to neurodevelopmental outcome at 18-24 months, considered as negative if one of the following was present: Mental Devel-opment Index (MDI)<85, motor, visual or hearing impairment.
Results. The severity of a-EEG, US and MRI alterations at each time point was not different according to the outcome. MDI was negatively correlated with aEEG score at 12h (R= -0.571, p=0.04) and with US score at 72h (R= -0.630, p=0.02). A positive correlation was found between aEEG score at 6h and US score at >7DOL(R=0.690, p=0.013). US alterations of the cortical matter at 72h were directly corre-lated with a-EEG score at 12h (R = 0.606, p=0.028) and 24h (R=0.605, p=0.029). Conclusions. Early instrumental evalua-tions, in particular aEEG and US, seem to predict neurodevelopmental outcome at 18-24 months in HIE newborns treated with hypothermia.
asphyxia, hypoxic-ischemic en-cephalopathy, hypothermia, newborn
ALICE MONZANI,GIANLUCA COSI,GIULIA GENONI,MARIA LAVRANO,CINZIA PERUZZI,ROBERTA POMELLA,FEDERICA FERRERO. Early instrumental predictors of long term neurodevelopmental impairment in newborns with perinatal asphyxia treated with therapeutic hypothermia. Signa Vitae. 2018. 14(1);81-85.
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