title: Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy.
abstract: OBJECTIVE
  This study was undertaken to determine the value of a neonatal encephalopathy score (ES) and the presence of seizures for predicting 30-month neurodevelopmental outcome.
  
  
  METHODS
  In a cohort study, 68 term newborn infants with encephalopathy were evaluated with an ES based on alertness, feeding, tone, respiratory status, reflexes, and seizure activity (range: 0-6). Seizures were noted as present or absent clinically. Significant cognitive deficits (Mental Development Index <70), motor disability (spastic triplegia/quadriplegia), or death were abnormal outcomes.
  
  
  RESULTS
  Twenty-two newborn infants (32%) had abnormal outcomes. With the use of maximum ES and presence of seizures from days 1 to 3 of life, 87% of newborn infants were correctly classified (area under receiver operating curve 0.93). By using ES and presence of seizures on day 1 only, 87% of newborn infants were correctly classified (area under receiver operating curve 0.89).
  
  
  CONCLUSIONS
  The severity of neonatal encephalopathy and the presence of seizures are valuable predictors of 30-month neurodevelopmental outcome, as early as the first day of life.
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, 94110, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Miller
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
authors.forename: Howard
authors.initials: H
authors.lastname: Clark
authors.forename: Alison
authors.initials: A
authors.lastname: Barnwell
authors.forename: David
authors.initials: D
authors.lastname: Glidden
authors.forename: A James
authors.initials: AJ
authors.lastname: Barkovich
authors.forename: Donna M
authors.initials: DM
authors.lastname: Ferriero
authors.forename: J Colin
authors.initials: JC
authors.lastname: Partridge
mesh_terms: D000375:Aging; D001927:Brain Diseases / Q000150:complications / Q000503:physiopathology*; D002657:Child Development; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn / Q000254:growth & development*; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012640:Seizures / Q000209:etiology / Q000503:physiopathology