Abstract
ObjectiveHypoxic-ischaemic encephalopathy (HIE) remains a leading cause of neonatal mortality and neurodisability. We aimed to determine the incidence of HIE and management patterns against national guidelines.DesignRetrospective cohort study using the...
Highlights
The incidence of moderate/severe Hypoxic ischaemic encephalopathy (HIE) in infants ≥36 weeks gestational age (GA) remained similar between epochs (Table 1) but Therapeutic hypothermia (TH) treatment significantly increased between epochs (54.6% vs 66.6%, p
62.1% (n=5069) of infants 36 weeks GA with moderate/severe HIE were cooled or died without TH. These infants were significantly more likely to have a background of acute intrapartum events, need for significant resuscitation, lower Apgar scores and lower cord venous pH compared to non -cooled infants
Mortality of infants 36 weeks GA with moderate/severe HIE was 9.3% (n=762) and decreased over time between epochs (10.0% vs 8.7%, OR 0.85, p=0.04)
Summary
Hypoxic ischaemic encephalopathy (HIE) remains a leading cause of neonatal mortality and neurodisability. Design Retrospective cohort study using the National Neonatal Research Database Setting Neonatal units in England and Wales Patients Infants 34 to 42 weeks gestational age (GA) with a recorded diagnosis of HIE Main Outcomes Incidence of HIE, mortality and treatment with therapeutic hypothermia (TH). Mild HIE and late preterm infants with HIE are undergoing TH, where the evidence base is lacking, highlighting the need for prospective studies to evaluate safety and efficacy in these populations. MET HODS Study Population The National Neonatal Research Database (NNRD) holds prospectively recorded daily clinical data from every infant admitted to UK neonatal units along with outcomes. Infants with moderate/severe HIE who died without undergoing TH were considered with babies that received TH for analysis as these are likely to represent infants who met cooling criteria but were too sick to undergo treatment or care was re-orientated; data for babies that died without undergoing TH are presented. All statistical analyses were performed using Stata SE (StataCorp, Version 15)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have