[Neurologic sequelae of hypoxic-ischemic encephalopathy].
The aim of this work was to determine the most important factors related to the appearance of neurodevelopmental impairment after neonatal hypoxic-ischemic encephalopathy (HIE). A total of 111 full-term neonates, affected by HIE and followed for at least 12 months, were studied. Three infants (2.8%) were severely impaired, 6 (5.6%) were moderately handicapped and 3 (2.8%) had mild impairment. The severity of neurological dysfunction (HIE: evaluated as 1 to 3 according to Amiel-Tison), the intensity of convulsions (CONVULS: 0 = not, 1 = only one, 2 = two or more, 3 = status), the presence of hypotension (HYPOTEN: 0 = no, 1 = yes), the need of assisted ventilation (VENTILO: 0 = no, 1 = yes) and the degree of the EEG's alteration (EEG: 0 to 3 according to Dreyfus-Brisac and Monod) were the factors that influenced both the appearance of neurodevelopmental impairment and its severity. On the other hand, umbilical artery pH, the scores of the Apgar tests, need of resuscitation and the presence of acute renal failure did not show any influence. By applying the formula [Discriminating value = 0.4116*HIE + 1.2470*CONVULS + 1.3699*HYPOTEN + 0.8263*VENTILO + 0.5155*EEGRN - 1.3471], a discriminating value of less than 2 predicts no neurodevelopmental impairment with a confidence limit of 95.9%, while a value greater than = 2 indicates a 80% probability of its manifestation. The sensitivity of this test is 66.7%, its specificity 97.4% and its accuracy 94.9%.
Figueras Aloy
J
J
Subdivisión de Pediatría, Hospital Clínico y Facultad de Medicina, Barcelona.
Roca González
A
A
López Santiveri
A
A
de la Rosa de los Ríos
C
C
Jiménez González
R
R
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000209:etiology; D002545:Brain Ischemia / Q000150:complications*; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications*; D007231:Infant, Newborn; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*
Secuelas neurológicas en la encefalopatía hipóxico-isquémica.