Department of Pediatric Neurology, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey.
Department of Neonatal Intensive Care Unit, Eskisehir Osmangazi University Hospital, Eskisehir, Turkey.
Acta Neurol Belg. 2023 Oct;123(5):1903-1909. doi: 10.1007/s13760-022-02126-5. Epub 2022 Nov 9.
Hypoxic ischemic encephalopathy (HIE) has different neurological outcomes.
We wanted to see if there was any developmental delay in neonates with hypoxia ischemic encephalopathy who were given therapeutic hypothermia.
Retrospective cohort study.
The Denver developmental screening test II (DDST-II) was performed to newborns who had been applied to therapeutic hypothermia.
There were 69 male and 36 female newborns. The mean 1-min and 5-min Apgar scores were 4.72 ± 2.51 and 7.03 ± 2.017, respectively. The mean pH and mean base excess were 6.92 ± 0.1 and -18.05 ± 5.72, respectively. The most common risk factors were meconium staining (17.1%). There were 67 patients with Stage I, 20 with Stage II, and 18 with Stage III. Diffusion restriction was seen in 13 patients. 28 patients had seizures. In aEEG, 12 patients had burst suppression. Three (2.9%) infants died during hospitalization. 19 patients missed follow-up appointments. Thirteen patients had abnormal development according to DDST-II. Seven patients had gross motor function delays and were diagnosed with cerebral palsy. Three had language skill delays, but two of them had speech disorders after two years of age. Two had delayed milestones. Two had delays in fine motor skills but did not have any sequels after two years of age. A significant difference was found between seizures and the severity of Sarnat stage, intubation in the delivery room with developmental delay. Apgar scores were significantly lower in patients with CP.
We should closely follow-up neonates who had low Apgar scores, seizures, a high Sarnat stage, were intubated in the delivery room.
缺氧缺血性脑病（HIE）有不同的神经结局。
我们想看看接受治疗性低温的缺氧缺血性脑病新生儿是否有发育迟缓。
回顾性队列研究。
对接受治疗性低温的新生儿进行丹佛发育筛查测试 II（DDST-II）。
共有 69 名男性和 36 名女性新生儿。1 分钟和 5 分钟 Apgar 评分分别为 4.72±2.51 和 7.03±2.017。pH 值和平均碱剩余分别为 6.92±0.1 和-18.05±5.72。最常见的危险因素是胎粪染色（17.1%）。Ⅰ期 67 例，Ⅱ期 20 例，Ⅲ期 18 例。13 例可见弥散受限。28 例有癫痫发作。aEEG 中，12 例有爆发抑制。3 例（2.9%）婴儿在住院期间死亡。19 例未按时随访。13 例根据 DDST-II 发育异常。7 例有粗大运动功能障碍，诊断为脑瘫。3 例有语言技能障碍，但其中 2 例在 2 岁后有言语障碍。2 例有发育迟缓。2 例有精细运动技能延迟，但在 2 岁后没有任何后遗症。癫痫发作和 Sarnat 分期严重程度、分娩室插管与发育迟缓之间存在显著差异。CP 患者的 Apgar 评分明显较低。
我们应密切随访低 Apgar 评分、癫痫发作、高 Sarnat 分期、分娩室插管的新生儿。
