Bolodár Anna, Nagy Eszter, Bodócs Dóra Luca, Rusznyák Eszter, Jermendy Ágnes, Szabó Miklós, Varga Zsuzsanna
1 Semmelweis Egyetem, Általános Orvostudományi Kar Budapest Magyarország.
2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, Neonatológiai Tanszék Budapest, Bókay J. u. 53., 1083 Magyarország.
Orv Hetil. 2025 Jun 22;166(25):990-999. doi: 10.1556/650.2025.33323.
Introduction: Data are limited about the detailed cognitive functions (e.g., language development) of children who survived neonatal hypoxic-ischemic encephalopathy without neurological impairment (quality survivors). Objective: A description of the prevalence of early language developmental delay and an examination of the differences in various linguistic indicators in quality survivors of hypoxic-ischemic encephalopathy. Method: Children who survived moderate to severe hypoxic-ischemic encephalopathy and received hypothermia treatment and participated in the developmental follow-up examination at 2 years of age were included in the prospective study conducted between 2017 and 2020. Developmental follow-up assessments utilized the Bayley-II Developmental (Cognitive) Scale, with a score of ≤85 indicating unfavorable cognitive outcomes. Language development was assessed using the MacArthur–Bates Communicative Development Inventory: Words and Sentences Forms. Early language delay was defined as expressive vocabulary falling below the 20th percentile despite average cognitive performance. Results: 50 patients were included in the study. Unfavorable cognitive developmental outcomes were observed in 23/50 (46%) cases, while favorable outcomes occurred in 27/50 (54%) cases. Examination of language development revealed early language delay in 10 children, while 17 exhibited typical language development. The occurrence of early language delay was higher compared to the general population (20% vs. 10–15%). The median (IQR) vocabulary size was 30 [20; 70] words in children with delayed language development, compared to 250 [159; 565] words in those with typical language development (p<0.001). The two groups also differed across all language indicators (e.g., use of morphemes and word combinations). Discussion: Quality survivors of hypoxic-ischemic encephalopathy exhibit a higher prevalence of early language delay compared to the general population. Based on our results, it appears that different levels of language, including the lexical and grammatical levels, are affected in children with hypoxic-ischemic encephalopathy who exhibited early language developmental delay but achieved favorable cognitive developmental outcomes. Conclusion: Our findings highlight the importance of examining domain-specific functions such as language development, even in children with favorable cognitive outcomes, as average cognitive function does not necessarily imply intact language abilities. Orv Hetil. 2025; 166(25): 990–999.
关于新生儿缺氧缺血性脑病存活且无神经功能障碍（质量存活者）儿童的详细认知功能（如语言发育）的数据有限。目的：描述早期语言发育迟缓的患病率，并检查缺氧缺血性脑病质量存活者各种语言指标的差异。方法：纳入2017年至2020年间进行的前瞻性研究中，中度至重度缺氧缺血性脑病存活且接受低温治疗并在2岁时参加发育随访检查的儿童。发育随访评估采用贝利-II发育（认知）量表，得分≤85表明认知结果不良。语言发育使用麦克阿瑟-贝茨交流发展量表：单词和句子形式进行评估。早期语言延迟定义为尽管认知表现平均，但表达性词汇量低于第20百分位。结果：50名患者纳入研究。23/50（46%）例观察到不良认知发育结果，27/50（54%）例为良好结果。语言发育检查显示10名儿童有早期语言延迟，17名表现为典型语言发育。早期语言延迟的发生率高于一般人群（20%对10 - 15%）。语言发育延迟儿童的词汇量中位数（IQR）为30[20；70]个单词，典型语言发育儿童为250[159；565]个单词（p<0.001）。两组在所有语言指标（如词素和单词组合的使用）上也存在差异。讨论：缺氧缺血性脑病质量存活者早期语言延迟的患病率高于一般人群。根据我们的结果，似乎不同水平的语言，包括词汇和语法水平，在缺氧缺血性脑病且有早期语言发育延迟但认知发育结果良好的儿童中受到影响。结论：我们的研究结果强调了检查特定领域功能如语言发育的重要性，即使在认知结果良好的儿童中也是如此，因为平均认知功能不一定意味着语言能力完整。《匈牙利医学周报》。2025年；166(25):990–999。
