Neurodevelopmental Evaluation in Full-term Newborns with Neonatal Hypoxic Ischemic Encephalopathy (HIE): A Case Control Study

Banu, Selina; Salim, A. F. M.; Ara, Rawnak; Akhter, Roksana; Khan, Naila Zaman

doi:10.3329/bjch.v39i1.28352

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…27 But on neurodevelopmental assessment, we found only 11.67% (7) neonate had normal development whereas development was mild, moderate and severely impaired in 10%, 33.33% and 20% neonates respectively. These findings are consistent with the findings of a study done by Banu et al 28 . In another study done by Khan et al 29 among preterm infants in Bangladesh, normal development was observed in 32%, mild impairments were found in 45%, and serious impairments were found in 23% of preterm infants.…”

Section: Resultssupporting

confidence: 94%

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Severity and immediate neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy admitted in NICU at a tertiary hospital in Bangladesh

Debnath

Khan

Mahfuz

et al. 2021

Bangladesh Crit Care J

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Background: Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity and long-term neurological deficits. Objective: The aim of the study was to determine the severity of encephalopathy and immediate neurodevelopmental outcomes in term neonates with HIE admitted in NICU at a tertiary care hospital. Materials and Methods: This was a Prospective Cohort study conducted between July 2016 and June 2017 at Dhaka Medical college Hospital, Dhaka. Asphyxiated term newborns who came within 12 hours of birth were enrolled in this study. Sarnat and Sarnat score was used to assess newborns immediately after birth to classify HIE. Neurodevelopmental assessment was performed using age specific rapid neurodevelopmental assessment tool (RNDA) at and 3 months after discharge to identify impairment in specific developmental domains. We determined the relation between severity of HIE and clinical outcome. Results: 60 patients were included in this study and their mean duration of hospital stay was 7.19 ± 5.26 days. The majority, 40% had moderate HIE, followed by 33.33%, 26.67% that had mild and severe HIE respectively. A total of 20% died, and most of them had severe HIE (83.33%). Normal development was found in only 11.67% cases. Moderate and severe neurodevelopmental impairment (NDI) was found in 33.33% and 25% cases respectively. At discharge, the most severely impaired domains were speech, seizure, primitive reflex and behaviour whereas at 3 months of age it was gross motor and seizure. When neurodevelopmental outcome was compared with different stages of encephalopathy, significant association was found between moderate to severe impairment/death with stage III of HIE. Conclusion: Apart from mortality, a significant proportion of term neonates with HIE developed NDIs and adverse neurodevelopmental outcomes was significantly associated with severity of encephalopathy. Bangladesh Crit Care J March 2021; 9(1): 22-27

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Section: Resultssupporting

confidence: 94%

“…These findings are similar with a study published earlier. 28 Our study found significant association between moderate to severe impairment/death with stage III of HIE when neurodevelopmental outcome was compared with different stages of encephalopathy. The association could be attributable to the severity of the brain lesion.…”

Section: Resultsmentioning

confidence: 49%

Severity and immediate neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy admitted in NICU at a tertiary hospital in Bangladesh

Debnath

Khan

Mahfuz

et al. 2021

Bangladesh Crit Care J

View full text Add to dashboard Cite

show abstract

“…In this study, on neurodevelopmental assessment, 11.67% (7) neonate had normal development whereas development was mild, moderate and severely impaired in 10% (6), 33.33% (20) and 20% (15) neonates respectively. These findings are consistent with the findings of a study done by Selina et al 21 in ICH and SSF Hospital, Mirpur, Dhaka. In another study done by Khan et al 22 among preterm infants in Bangladesh, normal development is observed in 32%, mild impairments are found in 45%, and serious impairments are found in 23% of preterm infants.…”

Section: Resultssupporting

confidence: 93%

Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

et al. 2019

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Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy. Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth. Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender. Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50). Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes. J Enam Med Col 2019; 9(3): 160-165

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“…This difference may be due to the adoption of different methodologies. In the study of Banu et al, 88.8% of patients had NDIs on initial assessment [14] which was higher than this study. Inclusion of only cases of moderate to severe degree of HIE may contribute to the high NDI identified in their study.…”

Section: Discussioncontrasting

confidence: 68%

Prediction of Neurodevelopmental Outcome of High-Risk Neonates: A study from a Tertiary Care Centre in Bangladesh

Banu¹,

Akhter

Fatema

et al. 2022

MJPCH

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Background: High-risk neonates are most vulnerable to develop neurodevelopmental impairment. Early identification and intervention can modify brain development and improve outcomes in neonates at risk for neurodevelopmental disorders. Objective: To predict the neurodevelopmental impairments (NDIs) in high-risk neonates. Methods: This observational study was conducted in the Department of Neonatology and Department of Paediatric Neurology, Institute of Paediatric Neurodisorder and Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from July 2019 to June 2020. A total of 85 high-risk term neonates were included in this study. A neurodevelopmental evaluation was completed using the rapid neurodevelopmental assessment instrument (RNDA) at neonatal (0 to 28 days) age and again at three months of age after a comprehensive history and clinical examination. Result: Among the enrolled 85 neonates at first assessment, NDI was found in 64.7% cases. Seizure was present in 49.4% cases and affected domains were cognition (48.2%), behavior (47.1%), hearing (45.9%), gross motor (41.2%), vision (42.3%), speech (42.3%), primitive reflexes (36.5 %) and fine motor (32.9%). At the age of 3 months, NDI was found in 47.1% and affected domains were gross motor (47.1%), speech (40.0%), fine motor (37.7%), vision (36.5%), cognition (36.5%), behavior (35.3%) and hearing (30.6%). The seizure was found in 29.4% of cases. A significant difference was found between the first and second assessment. Conclusion: NDI are common sequelae of high-risk neonates. The most frequently affected domains were gross motor, fine motor and speech. Thus, RNDA can be used to predict early NDI in high-risk newborns.

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Neurodevelopmental Evaluation in Full-term Newborns with Neonatal Hypoxic Ischemic Encephalopathy (HIE): A Case Control Study

Cited by 5 publications

References 18 publications

Severity and immediate neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy admitted in NICU at a tertiary hospital in Bangladesh

Severity and immediate neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy admitted in NICU at a tertiary hospital in Bangladesh

Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

Prediction of Neurodevelopmental Outcome of High-Risk Neonates: A study from a Tertiary Care Centre in Bangladesh

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