Moderate neonatal encephalopathy: pre- and perinatal risk factors and long-term outcome.
BACKGROUND
The aim was to describe pre- and perinatal data and long-term neurodevelopmental outcome (15-19 years) in children born at term with Apgar score <7 at 5 min and moderate neonatal encephalopathy.


METHODS
The study is based on a population-based birth-cohort of children born in Sweden in 1985. Maternal, delivery, neonatal, and neuropaediatric data were compiled. Neurodevelopmental status was classified according to the presence of 1. cerebral palsy or other major impairments, 2. exclusively cognitive impairments, and 3. no impairments.


RESULTS
The majority of the children (81%) had cognitive dysfunctions, with or without other impairments, such as cerebral palsy. The rates of post-term birth (19% versus 8%) and breech presentation (12% versus 3%) were significantly higher than in the general Swedish population. Pre- and perinatal data did not differ notably between the three outcome groups. Questionable or suboptimal obstetric care was common (55%).


CONCLUSIONS
The study shows that children born at term with moderate neonatal encephalopathy have a high rate of cognitive dysfunctions with or without cerebral palsy at long-term follow-up. Our pre- and perinatal data did not correlate with outcome.
Lindström
Katarina
K
Department of Neuropaediatrics, Children's Hospital, Karolinska University Hospital Huddinge, Stockholm, Sweden. katarina.lindstrom@ki.se
Hallberg
Boubou
B
Blennow
Mats
M
Wolff
Kerstin
K
Fernell
Elisabeth
E
Westgren
Magnus
M
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications* / Q000453:epidemiology; D002547:Cerebral Palsy / Q000453:epidemiology / Q000503:physiopathology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology