title: Long-term motor and behavioral outcome after perinatal hypoxic-ischemic encephalopathy.
abstract: BACKGROUND
  A cohort of children born with perinatal hypoxic-ischemic encephalopathy (HIE) was followed prospectively until school age.
  
  
  OBJECTIVE
  To describe motor outcome and behavioral functioning of school-age children after perinatal HIE and the relationship with neonatal MRI and outcome at age 2.
  
  
  METHODS
  Twenty-five children (19 males), born at term with perinatal HIE, were assessed at a mean age of 7 y 6 m (range 6 y 4 m-8 y 2 m). Motor ability was assessed with the Movement Assessment Battery for Children (2nd version) and behavioral functioning was assessed with the Child Behavior Checklist. Neonatal MRI was scored according to Barkovich classification.
  
  
  RESULTS
  Of the 25 included children, eight had cerebral palsy (CP). Of the 17 children without CP, nine had impaired motor ability (of which 3 scored definitely abnormal), and four had behavioral problems. There was a significant difference in motor performance (p = 0.008) between children with normal and children with abnormal neonatal MRI. Two (of four) children with normal motor ability and seven (of 14) children with normal neurological examination at age 2 showed impaired motor ability at school age.
  
  
  CONCLUSIONS
  Half of the children without CP had impaired motor ability at school age. A normal outcome after HIE at young age does not necessarily imply a good outcome at school age, even when neonatal MRI does not show any abnormalities. More research is needed on the behavioral and cognitive consequences of HIE at school age and on the consequences for quality of life for children with and without CP.
authors: Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Physical Therapy, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: pem.vanschie@vumc.nl.
authors: Petra E M
authors: PE
authors: van Schie
authors: Department of Child Neurology, VU University Medical Center, Amsterdam, Neuroscience Campus Amsterdam, The Netherlands.
authors: Josephine
authors: J
authors: Schijns
authors: Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: Jules G
authors: JG
authors: Becher
authors: Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
authors: Frederik
authors: F
authors: Barkhof
authors: Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.
authors: Mirjam M
authors: MM
authors: van Weissenbruch
authors: Department of Child Neurology, VU University Medical Center, Amsterdam, Neuroscience Campus Amsterdam, The Netherlands.
authors: R Jeroen
authors: RJ
authors: Vermeulen
mesh_terms: D002547:Cerebral Palsy / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000473:pathology*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008279:Magnetic Resonance Imaging; D008297:Male; D000068079:Motor Disorders / Q000453:epidemiology / Q000209:etiology*; D009460:Neurologic Examination; D011788:Quality of Life
keywords: CP; HIE; M-ABC-2; MRI; Motor outcome