Evoluzione neuropsichiatrica a lungo termine in soggetti con encefalopatia ipossico-ischemica neonatale

Abstract

We studied the neuropsychiatric evolution at school age in a population of children born at term with perinatal asphyxia, focusing on the assessment of cognitive disorders and psychopathological problems such as anxiety, depression and behavioural disorders. The cohort comprised 33 children aged between seven and 12 years, born at term and presenting hypoxic-ischaemic encephalopathy at birth. History-taking and neurological examination were done (according to Towen) and the following tests administered: WISC-R, test CBCL, childhood anxiety scale (Busnelli), CDI (Kovacs). A control group consisted of children aged between eight and 12 years without perinatal suffering. Results disclosed a number of evolutive disorders even though patients with severe neuromotor deficit were excluded from the study. Disorders included minor neurological syndromes, specific language and learning disorders, positivity on the scale for anxiety and depression: in particular 50% of the sample with minor neurological syndrome had symptoms of anxiety and depression. We divided the neonatal hypoxic-ischaemic encephalopathy into three degrees on the basis of brain scan and neurological examination. Relating the degree of neonatal hypoxic-ischaemic encephalopathy to some neuropsychological and psychiatric variables (cognitive level, anxiety, depression), only the correlation with anxiety was significant: the incidence of anxiety symptoms at school age was greater in the intermediate degree of neonatal hypoxic-ischaemic encephalopathy. Our findings further support the postulated link between neurological injury/dysfunction (perinatal asphyxia) and the subsequent onset of psychiatric and/or neuropsychological disorders.