One-year neurodevelopmental outcome after moderate newborn hypoxic ischaemic encephalopathy.
OBJECTIVE
To define the 1-year neurodevelopmental outcome for survivors of moderate (Sarnat stage 2) neonatal hypoxic-ischaemic encephalopathy (HIE) to facilitate appropriate parental counselling.


METHODS
Hospital-based retrospective review of admissions to a tertiary newborn intensive care unit between 1988 and 2000. All babies admitted for seizures were reviewed and those in whom the probable diagnosis was moderate HIE were identified from chart review. Perinatal variables, number of anticonvulsants, duration of hospital stay and 1-year neurodevelopmental outcome was recorded in survivors.


RESULTS
Fifty-three babies who survived probable moderate HIE were identified. Forty-two of these were seen at 1 year of age. Of these, 22 (52%) had normal development and neurological examination and four (9.5%) had mild developmental delay with normal neurological examination. Thirteen babies (31%) had cerebral palsy, 11 of whom also had developmental delay. Two infants (5%) who had been severely impaired at 6 months died before 1 year of age. Overall, 36% of survivors of the neonatal period had significant disability and or had died by 1 year of age. Duration of anticonvulsant treatment and length of hospital stay were significantly related to adverse outcome.


CONCLUSIONS
These data suggest morbidity rates after moderate HIE in the upper end of the range previously described in the literature. Systematic longer-term follow up of this high-risk group of infants is needed.
Department of Neonatal Medicine, Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia.
G
G
Carli
I
I
Reiger
N
N
Evans
D001034:Apgar Score; D001921:Brain / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology*; D007231:Infant, Newborn; D008297:Male; D019957:Motor Skills Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology*; D012720:Severity of Illness Index