Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy.
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.
Miller
Steven P
SP
Department of Neurology, University of California at San Francisco, San Francisco, 94110, USA.
Latal
Beatrice
B
Clark
Howard
H
Barnwell
Alison
A
Glidden
David
D
Barkovich
A James
AJ
Ferriero
Donna M
DM
Partridge
J Colin
JC
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