Original scientific paper
https://doi.org/10.22514/SV141.042018.14
Early instrumental predictors of long term neurodevelopmental impairment in newborns with perinatal asphyxia treated with therapeutic hypothermia
ALICE MONZANI
orcid.org/0000-0002-6676-5773
; Division of Pediatrics Department of Health Sciences, Università del Piemonte Orientale V. Solaroli 17, 28100 Novara, Italy
GIANLUCA COSI
GIULIA GENONI
MARIA LAVRANO
CINZIA PERUZZI
ROBERTA POMELLA
FEDERICA FERRERO
Abstract
Background. Hypoxic-ischemic encephalopathy
(HIE) is a leading cause of disability
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 electroencephalography
and neuroimaging
parameters as early predictors of neurodevelopmental
outcome in HIE newborns
treated with hypothermia.
Methods. We retrospectively evaluated 13
HIE patients treated with hypothermia
in January 2012-September 2014. We reviewed
their amplitude-integrated electroencephalography
(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 correlated
to neurodevelopmental outcome at 18-
24 months, considered as negative if one of
the following was present: Mental Development
Index (MDI)<85, motor, visual or
hearing impairment.
Results. Te severity of a-EEG, US and
MRI alterations at each time point was
not diferent 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 correlated
with a-EEG score at 12h (R = 0.606,
p=0.028) and 24h (R=0.605, p=0.029).
Conclusions. Early instrumental evaluations,
in particular aEEG and US, seem
to predict neurodevelopmental outcome
at 18-24 months in HIE newborns treated
with hypothermia.
Keywords
asphyxia; hypoxic-ischemic encephalopathy; hypothermia; newborn
Hrčak ID:
200442
URI
Publication date:
1.6.2018.
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