Teenage outcome after being born at term with moderate neonatal encephalopathy

Abstract

The aim of this study was to assess cognitive functions and behavior problems in teenagers who survived moderate neonatal encephalopathy and did not develop cerebral palsy. The study population comprised all 97,468 individuals born in Sweden in 1985. Of these, 684 (0.7%) were born at term and had an Apgar score of <7 at 5 minutes. The obstetric and neonatal records were scrutinized and the individuals were classified according to degree of neonatal encephalopathy. Teenagers with moderate neonatal encephalopathy without cerebral palsy and other major neuro-impairments were subjected to a clinical assessment including interviews, neuropsychological tests, and assessments of data from records. Age at examination was 15-19 years. Fifty-six individuals who had moderate neonatal encephalopathy were identified. Thirteen (23%) had parents who declined participation in the study. Of the remaining 43 subjects, 15 (30%) had a diagnosis of cerebral palsy or other major neuro-impairments and 28 had no such impairments. The latter group was examined, 20 of whom (71%) had definite cognitive dysfunctions. Five (18%) had hearing impairments. Only eight teenagers were without impairments. Of those who did not have cerebral palsy, the majority had cognitive/executive problems that interfered with their daily life situation. Clinical follow-up, including assessments of cognitive functions before school start, should be considered for all individuals in this high-risk group.