Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Neonatal Encephalopathy Suspected Hypoxic Ischaemic Encephalopathy (NESHIE) collaboration, South Africa.
S Afr Med J. 2020 Mar 30;110(4):308-312. doi: 10.7196/SAMJ.2020.v110i4.14311.
Neonatal hypoxic ischaemic encephalopathy (NHIE) is an important cause of long-term handicap in survivors. There is limited information on the burden of handicap from NHIE in sub-Saharan Africa.
To determine the developmental outcomes in survivors of NHIE in South Africa (SA).
In this prospective observational study, the developmental outcomes in 84 infants who had survived hypoxic ischaemic encephalopathy (the NHIE group) were compared with those in 64 unaffected infants (the control group). The Bayley Scales of Infant Development version III were used for assessment of developmental outcomes.
Significant differences were found between the developmental outcomes of the two groups, with a significantly lower composite language score and higher proportions with language, motor and cognitive developmental delays in the NHIE group than in the control group. Cerebral palsy (CP) was present in 13 of the infants with NHIE (15.5%) and none in the control group (p<0.001). CP was associated with developmental delay, and also with the severity of NHIE. Therapeutic hypothermia (TH) was administered in 58.3% of the study group, but although it was associated with lower rates of CP and developmental delay than in the group without TH, the only significant difference was for delay on the language subscale.
Survivors of NHIE in SA are at risk of poor developmental outcomes.
新生儿缺氧缺血性脑病（NHIE）是幸存者长期残疾的重要原因。在撒哈拉以南非洲地区，NHIE 导致残疾的负担信息有限。
确定南非 NHIE 幸存者的发育结果。
在这项前瞻性观察研究中，比较了 84 名缺氧缺血性脑病幸存者（NHIE 组）和 64 名未受影响婴儿（对照组）的发育结果。采用贝利婴幼儿发展量表第三版评估发育结果。
两组的发育结果存在显著差异，NHIE 组的综合语言评分明显较低，语言、运动和认知发育迟缓的比例明显较高。NHIE 组 13 名婴儿（15.5%）存在脑瘫（CP），对照组无脑瘫婴儿（p<0.001）。CP 与发育迟缓有关，也与 NHIE 的严重程度有关。研究组中 58.3%的婴儿接受了治疗性低温治疗（TH），但尽管与无 TH 组相比 CP 和发育迟缓的发生率较低，但唯一显著差异是语言分量表的延迟。
南非 NHIE 幸存者存在发育不良的风险。
