P123 – 2671: Follow up of neurodevelopmental outcome after therapeutic hypothermia for perinatal asphyxia

Abstract

Objective Neuroprotective benefit of therapeutic hypothermia in term newborns with hypoxic-ischemic encephalopathy was assessed by analyzing survival and neurodevelopmental outcome of neonates subjected to this procedure. Methods Newborns with gestational age of more than 36 weeks and less than 6 hours of age with moderate to severe asphyxial encephalopathy underwent cooling protocol at a temperature of 33.5 °C for 72 hours and rewarming period of 6 hours. The outcome measures assessed were death and neurodevelopmental characteristics, which we compared at the different age using ASQ-3, at least 3 times during follow-up. Results Twenty-five children were assessed during the period from October 2010 to October 2013. Median gestational age was 40 weeks, birth weight 3470 g, Apgar score 2/4 and pH on admission to the hospital 7.02. Four (16%) children died and two were lost for follow up. At the first assessment developmental categories of communication were normal in 68.4%, problem solving in 73.7%, personal-social in 68.4%, gross motor in 57.9%, and fine motor in 36.8% but with a high need of retesting in this area. Seven of 19 patients (36.8%) had completely normal results for all five categories, while three (15.8%) had abnormal results for all categories. Second assesment was done in 17 patients with developmental categories of communication normal in 70.5%, problem solving in 76.5%, personal-social in 70.5%, gross motor in 58.8%, and fine motor in 41.1%. Third evaluation was done in 13 patients: developmental categories of communication were normal in 69.2%, problem solving in 76.9%, personal-social in 69.2%, gross motor in 61.5%, and fine motor in 46.2%. Conclusion Relatively small number of patients and limitations of this study design precluded any far-reaching conclusions, but we think that therapeutic hypothermia in term newborns can provide better survival and less neurologic sequels in hypoxic-ischemic encephalopathy patients.