Abstract
Objective
This study was undertaken to determine the value of a neonatal encephalopathy score
(ES) and the presence of seizures for predicting 30-month neurodevelopmental outcome.
Study design
In a cohort study, 68 term newborn infants with encephalopathy were evaluated with
an ES based on alertness, feeding, tone, respiratory status, reflexes, and seizure
activity (range: 0-6). Seizures were noted as present or absent clinically. Significant
cognitive deficits (Mental Development Index <70), motor disability (spastic triplegia/quadriplegia),
or death were abnormal outcomes.
Results
Twenty-two newborn infants (32%) had abnormal outcomes. With the use of maximum ES
and presence of seizures from days 1 to 3 of life, 87% of newborn infants were correctly
classified (area under receiver operating curve 0.93). By using ES and presence of
seizures on day 1 only, 87% of newborn infants were correctly classified (area under
receiver operating curve 0.89).
Conclusion
The severity of neonatal encephalopathy and the presence of seizures are valuable
predictors of 30-month neurodevelopmental outcome, as early as the first day of life.
Keywords
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References
- Neurology of the newborn.Philadelphia, WB Saunders2001
- The asymptomatic newborn and risk of cerebral palsy.Arch Pediatr Adolesc Med. 1987; 141: 1333-1335
- Interventions for perinatal hypoxic-ischemic encephalopathy.Pediatrics. 1997; 100: 1004-1014
- Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome.J Pediatr. 1981; 98: 112-117
- Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study.BMJ. 1998; 317: 1554-1558
- Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study.BMJ. 1998; 317: 1549-1553
- Asphyxial complications in the term newborn with severe umbilical acidemia.Am J Obstet Gynecol. 1992; 167: 1506-1512
- Apgar scores as predictors of chronic neurologic disability.Pediatrics. 1981; 68: 36-44
- Long-term follow-up of term neonates with perinatal asphyxia.Clin Perinatol. 1993; 20: 483-500
- Early prognostic indicators of outcome in infants with neonatal cerebral infarction: a clinical, electroencephalogram, and magnetic resonance imaging study.Pediatrics. 1999; 103: 39-46
- Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study.Arch Neurol. 1976; 33: 696-705
- Newborn assessment and long-term adverse outcome: a systematic review.Am J Obstet Gynecol. 1999; 180: 1024-1029
- The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome.Acta Paediatr. 1997; 86: 757-761
- Early predictors of one-year outcome for infants asphyxiated at birth.Dev Med Child Neurol. 1986; 28: 303-309
- Amplitude-integrated electroencephalography coupled with an early neurologic examination enhances prediction of term infants at risk for persistent encephalopathy.Pediatrics. 2003; 111: 351-357
- Encephalopathy as a predictor of magnetic resonance imaging abnormalities in asphxiated newborns.Pediatr Neurol. 2003; 28: 342-346
- Antecedents of cerebral palsy,.Arch Pediatr Adolesc Med. 1985; 139: 1031-1038
- Early developmental outcomes after newborn encephalopathy.Pediatrics. 2002; 109: 26-33
- Proton MR spectroscopy for the evaluation of brain injury in asphyxiated, term neonates.AJNR Am J Neuroradiol. 1999; 20: 1399-1405
- Problems with definitions and classifications of newborn encephalopathy.Pediatr Neurol. 1992; 8: 85-90
- The Bayley scales of infant development II.New York Psychological Corporation, New York1993
- Early prediction of neurologic outcome after perinatal depression.Pediatr Neurol. 1999; 21: 788-793
- Social class and mental illness.John Wiley, New York1958
- Predictors of 30-month outcome after perinatal depression: role proton MRS and of socio-economic factors.Pediatr Res. 2002; 52: 71-77
- Seizure-associated brain injury in term newborns with perinatal asphyxia.Neurology. 2002; 58: 542-548
- Neonatal seizures: II, a multivariate analysis of factors associated with outcome.Pediatrics. 1982; 70: 177-185
- Predicting the outcome of postasphyxial hypoxic-ischemic encephalopathy within 4 hours of birth.J Pediatr. 1997; 131: 613-617
- The impact of low birth weight, perinatal conditions, and sociodemographic factors on educational outcome in kindergarten.Pediatrics. 1999; 104: e74
- Term infants with hypoxic-ischemic encephalopathy: outcome at 3.5 years.Dev Med Child Neurol. 1985; 27: 473-484
Article info
Publication history
Accepted:
July 15,
2003
Received in revised form:
June 26,
2003
Received:
May 2,
2003
Footnotes
☆This study was carried out in part in the Pediatric Clinical Research Center, Moffitt Hospital, University of California, San Francisco, with funds provided by the National Center for Research Resources, grant No. 5 M01 RR-01271, US Public Health Service, by National Institutes of Health grant No. NS35902, and the Canadian Institutes of Health Research.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.