Prempunpong C, Chalak L F, Garfinkle J, Shah B, Kalra V, Rollins N, Boyle R, Nguyen K-A, Mir I, Pappas A, Montaldo P, Thayyil S, Sánchez P J, Shankaran S, Laptook A R, Sant'Anna G
Mahidol University, Bangkok, Thailand.
University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Perinatol. 2018 Jan;38(1):80-85. doi: 10.1038/jp.2017.164. Epub 2017 Nov 2.
To determine short-term outcomes of infants with evidence of hypoxia-ischemia at birth and classified as mild neonatal encephalopathy (NE) at <6 h of age.
Prospective multicenter study. Mild NE was defined as ⩾1 abnormal category in modified Sarnat score. Primary outcome was any abnormality on early amplitude integrated electroencephalogram (aEEG) or seizures, abnormal brain magnetic resonance imaging (MRI) or neurological exam at discharge.
A total of 54/63 (86%) of enrolled infants had data on components of the primary outcome, which was abnormal in 28/54 (52%): discontinuous aEEG (n=4), MRI (n=9) and discharge exam (n=22). Abnormal tone and/or incomplete Moro were the most common findings. MRI abnormalities were confined to cerebral cortex but two infants had basal ganglia and/or thalamus involvement. The 18 to 24 months follow-up is ongoing.
A larger than expected proportion of mild NE infants with abnormal outcomes was observed. Future research should evaluate safety and efficacy of neuroprotection for mild NE.
确定出生时有缺氧缺血证据且在出生后<6小时被分类为轻度新生儿脑病（NE）的婴儿的短期预后。
前瞻性多中心研究。轻度NE定义为改良Sarnat评分中≥1个异常类别。主要结局为早期振幅整合脑电图（aEEG）或惊厥异常、出院时脑磁共振成像（MRI）异常或神经学检查异常。
共有54/63（86%）的入组婴儿有主要结局各组成部分的数据，其中28/54（52%）异常：aEEG不连续（n = 4）、MRI（n = 9）和出院检查（n = 22）。异常肌张力和/或不完全拥抱反射是最常见的表现。MRI异常局限于大脑皮层，但有两名婴儿累及基底神经节和/或丘脑。18至24个月的随访正在进行中。
观察到轻度NE婴儿出现异常结局的比例高于预期。未来的研究应评估针对轻度NE的神经保护的安全性和有效性。
