Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Lademann, Hanne; Abshagen, Karl; Janning, Anna; Däbritz, Jan; Olbertz, Dirk

doi:10.3390/healthcare9080994

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…The outcomes of a recent pilot study revealed that, at 24 months of age, late preterm infants with moderate HIE after TH demonstrated age-appropriate neurodevelopmental progress. However, the study strongly advised against using the data for clinical decision making [ 42 ]. In addition, the study reported a higher mortality rate in late preterm infants (34–35 weeks of GA) with HIE as compared to infants born ≥36 weeks of GA.…”

Section: Discussionmentioning

confidence: 99%

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

Okulu,

Hirfanoglu,

Satar

et al. 2023

PLoS ONE

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Background Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. Methods The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. Results The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p<0.001). No significant difference in mortality and abnormal MRI results was found according to the time of TH initiation (<3 h, 3–6 h and >6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34–35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34–35 weeks of GA (OR 3.941, 95% Cl 1.446–10.7422, p = 0.007). Conclusion The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether <3 or 3–6 h, did not result in lower occurrences of brain lesions on MRI or mortality. An increasing number of infants with mild HIE and late preterm infants with HIE are receiving TH; however, the indications for TH require further clarification. Longer follow-up studies are necessary for this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

Okulu,

Hirfanoglu,

Satar

et al. 2023

PLoS ONE

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“…However, treating these newborns by TH is regularly addressed in the literature4–6 and an RCT is underway in the USA (clinicaltrials.gov, no: NCT01793129). Currently, the only data are from small retrospective and/or single-centre studies7–9 and cannot reliably guide decision-making. To estimate prognosis, more information is needed.…”

Section: Introductionmentioning

confidence: 99%

Effect of gestational age on cerebral lesions in neonatal encephalopathy

Binet,

Debillon,

Beck

et al. 2024

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo determine the risk on brain lesions according to gestational age (GA) in neonates with neonatal encephalopathy.DesignSecondary analysis of the prospective national French population-based cohort, Long-Term Outcome of NeonataL EncePhALopathy.SettingFrench neonatal intensive care units.PatientsNeonates with moderate or severe neonatal encephalopathy (NE) born at ≥34 weeks’ GA (wGA) between September 2015 and March 2017.Main outcome measuresThe results of MRI performed within the first 12 days were classified in seven injured brain regions: basal ganglia and thalami, white matter (WM), cortex, posterior limb internal capsule, corpus callosum, brainstem and cerebellum. A given infant could have several brain structures affected. Risk of brain lesion according to GA was estimated by crude and adjusted ORs (aOR).ResultsMRI was available for 626 (78.8%) of the 794 included infants with NE. WM lesions predominated in preterm compared with term infants. Compared with 39–40 wGA neonates, those born at 34–35 wGA and 37–38 wGA had greater risk of WM lesions after adjusting for perinatal factors (aOR 4.0, 95% CI (1.5 to 10.7) and ORa 2.0, 95% CI (1.1 to 3.5), respectively).ConclusionWM is the main brain structure affected in late-preterm and early-term infants with NE, with fewer WM lesions as GA increases. This finding could help clinicians to estimate prognosis and improve the understanding of the pathophysiology of NE.Trial registration numberNCT02676063, ClinicalTrials.gov.

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Research Progress on Influencing Factors of Brain Injury in Premature Infants

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2022

ACM

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Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Cited by 4 publications

References 34 publications

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

Effect of gestational age on cerebral lesions in neonatal encephalopathy

Research Progress on Influencing Factors of Brain Injury in Premature Infants

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