Long Term Neurodevelopmental Outcome following Therapeutic Hypothermia for Perinatal Asphyxia

Introduction: Neuroprotective benefit of therapeutic hypothermia in term newborns with hypoxic-ischemic encephalopathy (HIE) was analyzed by survival and neuro-developmental outcome of neonates subjected to this procedure.

Material and Methods: Newborns with gestational age > 36 weeks and < 6 hours of age with moderate to severe asphyxial encephalopathy underwent cooling protocol at a temperature of 33.5 °C for 72 hours and rewarming period of 6 hours. Outcome measures assessed were death and neurodevelopmental characteristics, which were compared at the different age using ASQ3.

Results: 42 children were assessed at age 6-8months, 42 children at 12-14months. Median gestational age was 38 weeks, birth weight 2.8kg, Apgar score 2/4 and pH on admission to the hospital 7.02. Four (8%) children died. At the first assessment developmental categories of communication were normal in 61.9%, problem solving in 69.1%, personal-social in 61.9%, gross motor in 66.27%, and fine motor in 40.5% with a high need of retesting in this area. Second assessment was done in 42 patients: developmental categories of communication normal in 78.6%, problem solving in 76.2%, personal-social in 71.4%, gross motor in 81.0%, and fine motor in 50%.

Conclusion: There was no correlation between baseline parameters and outcome. Results of the study are showing that therapeutic hypothermia in term newborns can provide better survival and less neurologic sequels in HIE patients.

Table Baseline data at birth for patients enrolled in study