Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia.
10.3345/kjp.2016.59.11.440
- Author:
Sun Young SEO
1
;
Gyu Hong SHIM
;
Myoung Jae CHEY
;
Su Jeong YOU
Author Information
1. Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. sjyou@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Newborn;
Asphyxia;
Hypoxia-ischemia;
Brain;
Epilepsy
- MeSH:
Apgar Score;
Asphyxia*;
Brain;
Cerebral Palsy;
Electroencephalography;
Epilepsy;
Humans;
Infant*;
Infant, Newborn;
Intensive Care, Neonatal;
Lost to Follow-Up;
Neuroimaging;
Prospective Studies;
Retrospective Studies;
Seizures
- From:Korean Journal of Pediatrics
2016;59(11):440-445
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia. METHODS: All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2 years were included in this retrospective study. Abnormal neurological outcomes were defined as cerebral palsy, developmental delay and epilepsy. RESULTS: Of the 114 infants with perinatal asphyxia, 31 were lost to follow-up. Of the remaining 83 infants, 10 died, 56 had normal outcomes, and 17 had abnormal outcomes: 14 epilepsy (82.4%), 13 cerebral palsy (76.5%), 16 developmental delay (94.1%). Abnormal outcomes were significantly more frequent in infants with later onset seizure, clinical seizure, poor electroencephalography (EEG) background activity, lower Apgar score at 1 and 5 minutes and abnormal brain imaging (P<0.05). Infants with and without epilepsy showed significant differences in EEG background activity, clinical and electrographic seizures on EEG, Apgar score at 5 minutes and brain imaging findings. CONCLUSION: We should apply with long-term video EEG or amplitude integrated EEG in order to detect and management subtle clinical or electrographic seizures in neonates with perinatal asphyxia. Also, long-term, prospective studies with large number of patients are needed to evaluate more exact prognostic factors in neonates with perinatal asphyxia.
