Abstract
Introduction: Neonatal asphyxia is a major cause of infant morbidity in Cameroon. The aim of this study was to describe the short-term neurological outcome of children following neonatal Hypoxic-ischemic encephalopathy (HIE). Methodology: We conducted a retrospective cohort study from May 2010 to September 2013. We included 39 exposed cases against 78 non-exposed cases followed-up for at least 9 months. The variables studied were: age, sex, head circumference, neurological sequelae, postural anomalies and motor skills and developmental age/quotient. The data collected were analyzed using Epi info software version 3.5.3. The Fisher Exact Test was used to compare the variables with a significance threshold defined for p < 0.05. Results: We recruited 39 cases for 78 controls. The majority (74.40%) of cases were classified as HIE Sarnat 3 and 25.60% Sarnat 2. Most of the children were aged 12 - 36 months with a mean age of 18 months. The male sex was predominant with a sex ratio of 1.2; and 61.50% of children with HIE had head circumference < -2 Zscore. Thirtyone (79.50%) of the exposed cases developed a handicap against 2 (2.60%) in the control group. The handicaps were 61.54% severe, 10.26% moderate and 7.70% mild. The main sequelae were mental retardation (66.70%), cerebral palsy (46.20%) and epilepsy (30.80%). The associated anomalies were microcephaly and bucco facial dyspraxia. The neurosensory disorders consisted of blindness (41%), oculomotor disorders (18%) and deafness (7.70%). The mean developmental quotient in the cases was 49.59%. Conclusion: The frequency of neurological sequelae following HIE was high in our series. Efforts should be made to prevent perinatal asphyxia and to ensure the availability of material and staff trained to help babies’ breath in all the delivery rooms in our maternities.
Highlights
Neonatal asphyxia is a major cause of infant morbidity in Cameroon
The neurosensory disorders consisted of blindness (41%), oculomotor disorders (18%) and deafness (7.70%)
Data collection was done in three steps: Step 1: We looked for the history of perinatal asphyxia and the clinical evaluation of each child in the group of exposed cases according to the evaluation of the pediatric neurologist at 6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 24 months
Summary
Neonatal asphyxia is a major cause of infant morbidity in Cameroon. The aim of this study was to describe the short-term neurological outcome of children following neonatal Hypoxic-ischemic encephalopathy (HIE). The variables studied were: age, sex, head circumference, neurological sequelae, postural anomalies and motor skills and developmental age/quotient. Neonatal asphyxia is defined as the failure to establish or initiate normal breathing at birth [1] It is a common cause of severe permanent neurological damage in children. In Cameroon, the incidence varies from 18.6 to 113 per 1000 live births and perinatal asphyxia is the third cause of neonatal mortality after infection and complications of preterm births [3] [4]. For this reason perinatal asphyxia remains a real public health problem in our setting
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