Rotunda Hospital, Dublin 1, Ireland.
The Children's University Hospital, Temple St, Dublin 1, Ireland.
Eur J Pediatr. 2018 Jan;177(1):19-32. doi: 10.1007/s00431-017-3028-3. Epub 2017 Oct 24.
To access outcome following hypoxic ischemic encephalopathy (HIE), survivors without cerebral palsy were invited for formal developmental assessment. Children aged ≥ 42 months were assessed using the NEPSY-2, Movement Assessment Battery for Children 2 (Movement ABC-2), Behavior Rating Inventory of Executive Function, and the Child Behavior Checklist. Children aged < 42 months were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSITD-3). One hundred forty-six children attended for assessments [Grade 1 (112), Grade 2 (33), and Grade 3 (1)]. BSITD-3 did not identify significant rates of impairment on cognitive, motor, or language subtests. A significant proportion of children scored < 3rd percentile on the adaptive behavior scale. In older age groups, difficulties were seen in 16/24 NEPSY-2 subtests and on timed assessments using Movement ABC-2. Difficulties arose especially in the "control" aspects of cognition and behavior. Behavioral difficulties were common with internalizing problems predominating. There was a graded effect with grade 2 cases differing significantly from grade 1 cases.
Following HIE, children may experience attention, memory, and behavior difficulties which are not always evident at a young age. The adaptive behavior questionnaire may be a useful tool to select children requiring developmental surveillance beyond 2 years of age. What is known: • Diversity of outcome across grades of HIE is reported and few studies have looked at the milder consequences of HIE at school age. What is new: • Following HIE children may experience attention, memory, and behavior difficulties which are not always evident at a young age. • The adaptive behavior questionnaire may be a useful tool to select children requiring developmental surveillance beyond 2 years of age.
为了评估缺氧缺血性脑病（HIE）后患儿的结局，我们邀请无脑性瘫痪的幸存者进行正式的发育评估。年龄≥42 个月的患儿使用神经心理发育评估第二版（NEPSY-2）、儿童运动评估测试（Movement ABC-2）、执行功能行为评定量表（BRIEF）和儿童行为检查表（CBCL）进行评估。年龄＜42 个月的患儿使用贝利婴幼儿发育量表第三版（BSITD-3）进行评估。共有 146 名患儿接受了评估[1 年级（112 名）、2 年级（33 名）和 3 年级（1 名）]。BSITD-3 未发现认知、运动或语言子测试存在显著障碍。相当一部分患儿在适应行为量表上的得分＜第 3 百分位。在年龄较大的儿童中，在 24 项 NEPSY-2 子测试和使用 Movement ABC-2 的计时测试中存在困难。认知和行为的“控制”方面存在困难。行为问题很常见，以内心问题为主。随着年级的升高，2 年级的患儿与 1 年级的患儿差异显著。
HIE 后，患儿可能会出现注意力、记忆力和行为方面的困难，而这些问题在幼儿期并不总是明显的。适应性行为问卷可能是选择需要在 2 岁以上进行发育监测的儿童的有用工具。已知情况：HIE 各年级的结局存在差异，很少有研究关注 HIE 在学龄期的较轻后果。新发现：HIE 后患儿可能会出现注意力、记忆力和行为方面的困难，而这些问题在幼儿期并不总是明显的。适应性行为问卷可能是选择需要在 2 岁以上进行发育监测的儿童的有用工具。
