Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia

다국어 초록 (Multilingual 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.

참고문헌 (Reference)

1 김지훈, "발달 지연아에서 한국형 영유아 발달 검사와 베일리 영유아 발달 검사의 비교 분석" 대한소아과학회 52 (52): 772-777, 2009

2 Srinivasakumar P, "Treating EEG seizures in hypoxic ischemic encephalopathy: a randomized controlled trial" 136 : e1302-e1309, 2015

3 Al-Macki N, "The spectrum of abnormal neurologic outcomes subsequent to term intrapartum asphyxia" 41 : 399-405, 2009

4 Soltirovska-Salamon A, "Risk factors and scoring system as a prognostic tool for epilepsy after neonatal seizures" 50 : 77-84, 2014

5 van Laerhoven H, "Prognostic tests in term neonates with hypoxic-ischemic encephalopathy: a systematic review" 131 : 88-98, 2013

6 Lai YH, "Prognostic factors of developmental outcome in neonatal seizures in term infants" 54 : 166-172, 2013

7 Garfinkle J, "Prognostic factors and development of a scoring system for outcome of neonatal seizures in term infants" 15 : 222-229, 2011

8 Garfinkle J, "Predictors of outcome in term infants with neonatal seizures subsequent to intrapartum asphyxia" 26 : 453-459, 2011

9 Ortibus EL, "Predictive value of EEG for outcome and epilepsy following neonatal seizures" 98 : 175-185, 1996

10 Clancy RR, "Postnatal epilepsy after EEG-confirmed neonatal seizures" 32 : 69-76, 1991

11 Rei M, "Neurological damage arising from intrapartum hypoxia/acidosis" 30 : 79-86, 2016

12 Abend NS, "Neonatal seizures and status epilepticus" 29 : 441-448, 2012

13 Scher MS, "Neonatal seizures and brain damage" 29 : 381-390, 2003

14 Temko A, "Multimodal predictor of neurodevelopmental outcome in newborns with hypoxic-ischaemic encephalopathy" 63 : 169-177, 2015

15 Shah DK, "Monitoring of seizures in the newborn" 97 : F65-F69, 2012

16 Massaro AN, "MRI for neurodevelopmental prognostication in the high-risk term infant" 39 : 159-167, 2015

17 Dudek FE, "Is neuronal death necessary for acquired epileptogenesis in the immature brain?" 10 : 95-99, 2010

18 van Rooij LG, "Effect of treatment of subclinical neonatal seizures detected with aEEG: randomized, controlled trial" 125 : e358-e366, 2010

19 Glass HC, "Clinical neonatal seizures are independently associated with outcome in infants at risk for hypoxic-ischemic brain injury" 155 : 318-323, 2009

20 Levine MS, "Cerebral palsy diagnosis in children over age 1 year: standard criteria" 61 : 385-389, 1980

21 Limperopoulos C, "Association between electroencephalographic findings and neurologic status in infants with congenital heart defects" 16 : 471-476, 2001

22 Kim HJ, "A study of the correlation between BSID-III and KICDT for children with developmental delay" 27 : 269-271, 2015