Serial Assessment of Neurodevelopmental Outcome following Neonatal Encephalopathy and Therapeutic Hypothermia

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Abstract

Objective: To compare the neurodevelopmental outcome at 18-24 months, 5-6 years, and 8-10 years of age among children who received therapeutic hypothermia (TH) for neonatal encephalopathy (NE) following perinatal asphyxia. Study design: A retrospective, multicenter cohort study was performed in children with NE treated with TH at 2 level III neonatal intensive care units between January 2008 and December 2015, with neurodevelopmental testing at 18-24 months (visit 1), 5-6 years (visit 2), and 8-10 years (visit 3). Motor, cognitive, and behavioral scores, derived from standardized neurodevelopmental tests, were converted to Z-scores and compared across the visits using linear mixed modeling. Results: Seventy-seven children were analyzed. In linear mixed modeling, motor Z-scores decreased nonlinearly throughout the follow-up visits, being lower among children with a lower total IQ at 8-10 years and deep gray matter injury on neonatal brain magnetic resonance imaging. Cognitive Z-scores decreased among children with mammillary body abnormalities on neonatal magnetic resonance imaging, and were significantly lower in children with a lower gestational age and lower socioeconomic status. Z-scores indicating internalizing behavioral problems increased linearly (visit 1: median −0.7, IQR 1.4; visit 2: median −0.5, IQR 1.2; visit 3: median −0.1, IQR 1.5). Conclusions: Motor, cognitive, and behavioral Z-scores significantly worsened from 2 to 8-10 years among children who received TH for NE, highlighting the importance of long-term developmental surveillance.

Original languageEnglish
Article number114679
JournalThe Journal of Pediatrics
Volume285
Early online date5 Jun 2025
DOIs
Publication statusPublished - Oct 2025

Keywords

  • magnetic resonance imaging
  • neonatal encephalopathy
  • neurodevelopmental outcome
  • perinatal asphyxia

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