Prognostic factors of the developmental outcome in neonates after hypoxic ischemic encephalopathy

Abstract

Background and objective: The objectives of this study were to identify the etiologic profile and neurodevelopmental outcome of hypoxic-ischemic encephalopathy, and determine the usefulness of brain imaging to predict neurodevelopmental outcome. Method: A prospective cross-sectional hospital based study was done on fifty term neonates admitted in the neonatal care. All the neonates included in the study were born on term (≥37 weeks of gestation) with perinatal asphyxia, admitted to the neonatal intensive care unit during the study period. All neonates included in the study underwent the first cranial ultrasonography at 6 month. Follow up of neurodevelopmental examination was done at 6 months of age, to determine the relationship between prognosis and the staging of encephalopathy with imaging methods. Results: A total of 50 newborns enrolled in the current study with a mean APGAR Score ± S.D of 4.1 at first minute and 6.5 at fifth minutes consecutively. More than half of the mothers were primigraivda (64%), and most of them had normal vaginal delivery (76%) and 62% of them had prolonged labour. The majority (82%) of the babies had delayed initial crying after birth and 30% with abnormal brain ultrasonography. Half of the newborns (54%) had poor outcome as developmental delay. Conclusions: This study showed a significant relationship between low APGAR score and perinatal asphyxia. This scoring system is based on clinical evaluation, brain imaging and prognosis or neurodevelopmental delay. Most of infants with abnormal brain ultrasonography at 6 months, had developmental delay while those of normal brain imaging had favorable outcome.