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Early instrumental predictors of long term neurodevelopmental impairment in newborns with perinatal asphyxia treated with therapeutic hypothermia

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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… Click to show full abstract

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) 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.

Keywords: term; hypothermia; long term; instrumental predictors; treated hypothermia; early instrumental

Journal Title: Signa Vitae
Year Published: 2018

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