title: Comparison of psychomotor outcome in patients with perinatal asphyxia with versus without therapeutic hypothermia at 4 years using the Ages and Stages Questionnaire screening tool.
abstract: BACKGROUND
  Therapeutic hypothermia improves outcome after perinatal asphyxia. The Ages and Stages Questionnaire is a screening tool to detect neurodevelopmental delay. In this study we examined the outcome of patients with perinatal asphyxia (defined as Apgar score <5 at 10 min, or continued need for resuscitation, or pH < 7.00 in umbilical cord or within one hour after birth) with and without therapeutic hypothermia treatment at the age of four years.
  
  
  METHODS
  Cohort study of patients with perinatal asphyxia admitted to the Neonatal Intensive Care Units of the VU University Medical Center, Amsterdam and the Wilhelmina Children's Hospital, Utrecht in the year 2008. Parents were asked to fill out the 48 months Ages and Stages Questionnaire (ASQ). In Wilhelmina Children's Hospital treatment with therapeutic hypothermia was implemented in 2008, in the VU University Medical Center in 2009, providing a historical cohort.
  
  
  CONCLUSIONS
  Twenty-three questionnaires were evaluated. Response rate of questionnaires for the VU Medical Center was 63% (n = 10) and Wilhelmina's Childrens Hospital 93% (n = 13). No significant differences were found in the mean scores between both groups. However, the untreated group scored more frequently under the -2 SD threshold. In the fine motor skills domain the difference was statistically significant (p = 0.031). In the treated group no patients developed cerebral palsy and in the untreated group two patients developed cerebral palsy.
  
  
  CONCLUSIONS
  In this study patients treated with hypothermia tend to have a better neurodevelopmental outcome. No significant differences were found between the two groups, apart from the fine motor skills.
authors.affiliation: Department of Neonatology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. Electronic address: i.zonnenberg@vumc.nl.
authors.forename: I A
authors.initials: IA
authors.lastname: Zonnenberg
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital/ University Medical Center, Lundlaan 6, 3584 EA, Utrecht, The Netherlands. Electronic address: C.Koopman@umcutrecht.nl.
authors.forename: C
authors.initials: C
authors.lastname: Koopman
authors.affiliation: Department Rehabilitation Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. Electronic address: pem.vanschie@vumc.nl.
authors.forename: P E M
authors.initials: PE
authors.lastname: van Schie
authors.affiliation: Department of Child Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. Electronic address: jeroen.vermeulen@mumc.nl.
authors.forename: R J
authors.initials: RJ
authors.lastname: Vermeulen
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital/ University Medical Center, Lundlaan 6, 3584 EA, Utrecht, The Netherlands. Electronic address: F.Groenendaal@umcutrecht.nl.
authors.forename: F
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. Electronic address: m.vanweissenbruch@vumc.nl.
authors.forename: M M
authors.initials: MM
authors.lastname: van Weissenbruch
mesh_terms: D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D008297:Male; D009048:Motor Skills; D011247:Pregnancy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Ages and Stages Questionnaire; Developmental outcome; Hypothermia; Perinatal asphyxia