Neurodevelopmental Outcomes in Neonates with Mild Hypoxic Ischemic Encephalopathy Treated with Therapeutic Hypothermia

Abstract

Objective: To review developmental outcomes of neonates with mild hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH).

Study design: Neonates ≥35 weeks' gestation with mild HIE/TH (TH group, n = 30) were matched with healthy term-born infants (control group, n = 30) and reviewed for the presence and severity of magnetic resonance imaging (MRI)-detected neurological injury. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant Development (BSID).

Results: MRI injury was present in 13/30 (43.3%) neonates (11 mild, 1 moderate, and 1 severe injuries) in the TH group. The mean (standard deviation [SD]) corrected age at BSID III was 29.3 (3.9) months in the controls compared with 14.7 (3.9) months in the TH group (p < 0.01). The mean (SD) cognitive, language, and motor composite scores in neonates in the TH group (n = 16, 53.3%) and control groups (n = 30, 100%) were 99.4 (17.1) versus 93.0 (12.3), (p = 0.15), 89.5 (15.5) versus 100.2 (18.4), (p = 0.054), and 93.1 (15.4) versus 100.8 (16.3) (p = 0.13), respectively.

Conclusion: Developmental outcomes of neonates with mild HIE/TH were similar to healthy, term-born neonates.

Fig. 1

Neurodevelopmental follow-up and neuroimaging data of neonates with mild HIE treated with TH. BSID, Bayley Scales of Infant Development; HIE, hypoxic-ischemic encephalopathy; MR, magnetic resonance; TH, therapeutic hypothermia.

Fig. 2

BSID III scores in control group versus TH group. There were no differences in the composite scores between the two groups (p = 0.15, 0.054, and 0.13 for cognitive, language, and motor scores, respectively). BSID, Bayley Scales of Infant Development.

Fig. 3

BSID III composite scores in the three domains comparing control and TH groups by severity of MRI injury. There were no differences in the composite scores between those with injury and without injury. The moderate and severe scores were combined together for this analysis. BSID, Bayley Scales of Infant Development; MRI, magnetic resonance imaging. (A) Cognitive scores, (B) language scores, and (C) motor scores.