title: Long-term neurodevelopmental outcome with hypoxic-ischemic encephalopathy.
abstract: OBJECTIVE
  To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits.
  
  
  METHODS
  Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or mental retardation). Brain injury was scored according to the region and extent of injury.
  
  
  RESULTS
  Children without major disability (n = 57) had lower full-scale and performance IQ scores compared with norms (P = .02 and .01, respectively), and the proportion of children with an IQ <85 was higher than expected (P = .04). Motor performance on the Zurich Neuromotor Assessment was affected in the pure motor, adaptive fine motor, and gross motor domains, as well as in the movement quality domain (all P < .001). Watershed injury pattern on neonatal MRI correlated with full-scale and verbal IQ scores (P = .006 and <.001, respectively), but neonatal MRI pattern did not correlate with motor performance in children without major disability.
  
  
  CONCLUSIONS
  Children who sustained neonatal HIE without major disability are at increased risk for long-term intellectual, verbal, and motor deficits. The severity of watershed injury is correlated with later intellectual performance. Long-term follow-up examinations are necessary for early detection of neurodevelopmental impairment and early initiation of adequate therapies.
authors.affiliation: Child Development Center, Zurich University Children's Hospital, Zurich, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Perez
authors.forename: Susanne
authors.initials: S
authors.lastname: Ritter
authors.forename: Barbara
authors.initials: B
authors.lastname: Brotschi
authors.forename: Helene
authors.initials: H
authors.lastname: Werner
authors.forename: Jon
authors.initials: J
authors.lastname: Caflisch
authors.forename: Ernst
authors.initials: E
authors.lastname: Martin
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000209:etiology*; D002648:Child; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000175:diagnosis; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
keywords: CP; Cerebral palsy; HIE; Hypoxic-ischemic encephalopathy; MRI; Magnetic resonance imaging; ZNA; Zurich Neuromotor Assessment