van Handel Mariëlle, Swaab Hanna, de Vries Linda S, Jongmans Marian J
Department of Neonatology, University Medical Center Utrecht (Wilhelmina Children's Hospital), Heidelberglaan 1, 3584 CS Utrecht, P.O. Box 85500, 3500 GA, Utrecht, The Netherlands.
Eur J Pediatr. 2007 Jul;166(7):645-54. doi: 10.1007/s00431-007-0437-8. Epub 2007 Apr 11.
Neonatal encephalopathy (NE) following perinatal asphyxia (PA) is considered an important cause of later neurodevelopmental impairment in infants born at term. This review discusses long-term consequences for general cognitive functioning, educational achievement, neuropsychological functioning and behavior. In all areas reviewed, the outcome of children with mild NE is consistently positive and the outcome of children with severe NE consistently negative. However, children with moderate NE form a more heterogeneous group with respect to outcome. On average, intelligence scores are below those of children with mild NE and age-matched peers, but within the normal range. With respect to educational achievement, difficulties have been found in the domains reading, spelling and arithmetic/mathematics. So far, studies of neuropsychological functioning have yielded ambiguous results in children with moderate NE. A few studies suggest elevated rates of hyperactivity in children with moderate NE and autism in children with moderate and severe NE.
Behavioral monitoring is required for all children with NE. In addition, systematic, detailed neuropsychological examination is needed especially for children with moderate NE.
围产期窒息(PA)后的新生儿脑病(NE)被认为是足月出生婴儿后期神经发育障碍的重要原因。本综述讨论了对一般认知功能、学业成就、神经心理功能和行为的长期影响。在所有综述的领域中,轻度NE患儿的结果始终是积极的,而重度NE患儿的结果始终是消极的。然而,中度NE患儿在结果方面构成了一个更为异质的群体。平均而言,智力得分低于轻度NE患儿和年龄匹配的同龄人,但仍在正常范围内。在学业成就方面,在阅读、拼写和算术/数学领域发现了困难。到目前为止,对中度NE患儿神经心理功能的研究结果尚不明确。一些研究表明,中度NE患儿多动率升高,中度和重度NE患儿患自闭症的比例升高。
所有NE患儿都需要进行行为监测。此外,特别是对于中度NE患儿,需要进行系统、详细的神经心理检查。