Gender and age related adverse effects of child’s hypoxic-ischemic encephalopathy

Abstract

Introduction. Among the causes of childhood disability, the consequences of hypoxic-ischemic encephalopathy (HIE) transmitted in the neonatal period are the most significant. Annually in developed countries, 1-8 neonates per 1,000 are diagnosed with HIE. The incidence rate is twice as high in low- and middle-income countries. Among them, every 4th child with this diagnosis has adverse consequences of the disease sort of severe neurological pathologies such as epilepsy and cerebral palsy (CP). Researchers are particularly interested in the easy course of HIE and the ability to predict its consequences. Aim of the research. To establish the gender and age characteristics of the adverse effects of HIE in preschool children. Materials and methods. The study is prospective, carried out on all its stages in the neonatology center and the center of follow-up observation of Vinnytsia Regional Children's Clinical Hospital VOR, 214 children aged 0 to 6 years were examined. The prospective study included 174 children born full-term and in the neonatal period suffered HIE of various severity. Results. The results of follow-up were analyzed at 1, 3 and 6 years. The formation of disability had gender and age related features. Thus, among 23 children with disabilities, boys predominated - 16 (69.57%). With age, the number of children with disabilities increased from 14 (9.52%) in 1 year to 23 (15, 65%) in 3 years and remained unchanged at the age of 6 years. More than half of children had mental and language retardation at the age of 1. Thus, among 23 children with disabilities, boys predominated - 16 (69.57%). With age, the number of children with disabilities increased from 14 (9.52%) at 1 year of age to 23 (15.65%) among 3-agers and remained unchanged among 6-agers. More than half of children had mental and language retardation at the age of 1. As they reached the age of 6, their number decreased to 25% girls and 41.2% boys. Certainly, majority of these children were among patients with severe GIE in the neonatal period. 20 (13.61%) children had episyndrome at the age of 1 year, 11 (55.0%) of them - prevailing boys. For the children aged 3 with slight and moderate HIE, the diagnosis was disaffirmed. Among 6-olders with spasms boys prevailed. At the age of 6 years among children with convulsions significantly prevailed boys 12 (63.16%). Among concomitant pathologies of children with HIE consequences there prevailed anemia at the age of 3 years, found in 1 of 4 girls and 1 of 5 boys severe HIE history, ophthalmic diseases fou nd among 23.5% of boys in this group and bronchial asthma - among 9.52%. Child mortality with HIE in the neonatal period, in the first 6 years of life was 2.72%. Conclusions. The formation of adverse effects of HIE in children had gender and age characteristics. Boys predominated among children with disabilities, they were more likely to have mental and language retardation and episyndrome. With age, the number of children with adverse effects has decreased, with the exception of the disabled, whose number has increased. Key words: hypoxic-ischemic encephalopathy, disability, cerebral palsy, episyndrome, gender differences.