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Minor neurological signs and behavioural function at age 2 years in neonatal hypoxic ischaemic encephalopathy (HIE)

Minor neurological signs and behavioural function at age 2 years in neonatal hypoxic ischaemic encephalopathy (HIE)
Minor neurological signs and behavioural function at age 2 years in neonatal hypoxic ischaemic encephalopathy (HIE)
Background: neurodevelopmental follow-up in Neonatal Hypoxic Ischaemic Encephalopathy (HIE) typically focusses on major neuromotor (cerebral palsy, CP) and severe cognitive impairment. Outcomes in those without major neuromotor impairment are less well explored.

Objectives: to examine behavioural, cognitive and neurological outcomes after neonatal HIE, in a clinical cohort of children without CP, at age 2 years.

Methods: clinical routine outcome data from children admitted to a tertiary centre with neonatal HIE for hypothermia treatment between 05/08/09 - 30/05/2016. Children were assessed for neuromotor status – particularly minor neurological signs (MNS), with Bayley Scales of Infant and Toddler Development III (Bayley III) or Ages and Stages Questionnaire-3 (ASQ), Child Behavior Checklist 1.5-5 (CBCL), Quantitative Checklist for Autism in Toddlers (Q-CHAT).

Results: of 107 children, 75.5% had normal neurology, 12.1% CP, 12.1% MNS. Children with CP were excluded from analyses. For those without CP, Bayley-III scores were in the average range for the majority; mild cognitive delay observed in 5%, 4.2% language, 1.3% motor development; severe delay in 1.3% for cognitive, 4.2% for language. More than in the normative population scored in clinical ranges for CBCL externalising, sleep, and other problems. No significant difference was seen for Q-CHAT. Children with MNS were significantly more likely to have impaired Bayley-III scores, parent-reported internalising, sleep, and other problems.

Conclusions: in this clinical cohort, the majority of children had favourable outcome at 2 years. However, children with MNS were at risk for cognitive and behavioural difficulties and will benefit from enhanced clinical follow-up and support.
Minor neurological signs, Neonatal hypoxic ischaemic encephalopathy (HIE), Neurodevelopmental, Neuromotor, Therapeutic hypothermia
1090-3798
78-85
Edmonds, Caroline
f78a8541-0dca-4e94-9c70-a935fbbcd838
Helps, Suzannah K.
a80e9c33-f85b-4ecf-b956-9312a6f61fae
Denise, Hart
16e842cd-24e1-41dc-8030-868b295e48f1
Zatorska, Anna
774151f0-591f-410a-9a39-5703340c7dbd
Cianfaglione, Rina
bf9b4507-4a79-4f72-b7e2-7244b9dea9ef
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Edmonds, Caroline
f78a8541-0dca-4e94-9c70-a935fbbcd838
Helps, Suzannah K.
a80e9c33-f85b-4ecf-b956-9312a6f61fae
Denise, Hart
16e842cd-24e1-41dc-8030-868b295e48f1
Zatorska, Anna
774151f0-591f-410a-9a39-5703340c7dbd
Cianfaglione, Rina
bf9b4507-4a79-4f72-b7e2-7244b9dea9ef
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba

Edmonds, Caroline, Helps, Suzannah K., Denise, Hart, Zatorska, Anna, Cianfaglione, Rina and Vollmer, Brigitte (2020) Minor neurological signs and behavioural function at age 2 years in neonatal hypoxic ischaemic encephalopathy (HIE). European Journal of Paediatric Neurology, 27, 78-85. (doi:10.1016/j.ejpn.2020.04.003).

Record type: Article

Abstract

Background: neurodevelopmental follow-up in Neonatal Hypoxic Ischaemic Encephalopathy (HIE) typically focusses on major neuromotor (cerebral palsy, CP) and severe cognitive impairment. Outcomes in those without major neuromotor impairment are less well explored.

Objectives: to examine behavioural, cognitive and neurological outcomes after neonatal HIE, in a clinical cohort of children without CP, at age 2 years.

Methods: clinical routine outcome data from children admitted to a tertiary centre with neonatal HIE for hypothermia treatment between 05/08/09 - 30/05/2016. Children were assessed for neuromotor status – particularly minor neurological signs (MNS), with Bayley Scales of Infant and Toddler Development III (Bayley III) or Ages and Stages Questionnaire-3 (ASQ), Child Behavior Checklist 1.5-5 (CBCL), Quantitative Checklist for Autism in Toddlers (Q-CHAT).

Results: of 107 children, 75.5% had normal neurology, 12.1% CP, 12.1% MNS. Children with CP were excluded from analyses. For those without CP, Bayley-III scores were in the average range for the majority; mild cognitive delay observed in 5%, 4.2% language, 1.3% motor development; severe delay in 1.3% for cognitive, 4.2% for language. More than in the normative population scored in clinical ranges for CBCL externalising, sleep, and other problems. No significant difference was seen for Q-CHAT. Children with MNS were significantly more likely to have impaired Bayley-III scores, parent-reported internalising, sleep, and other problems.

Conclusions: in this clinical cohort, the majority of children had favourable outcome at 2 years. However, children with MNS were at risk for cognitive and behavioural difficulties and will benefit from enhanced clinical follow-up and support.

Text
EJPN-D-19-00034_Vollmer - REVISION_1 - Accepted Manuscript
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More information

Accepted/In Press date: 7 March 2020
e-pub ahead of print date: 11 April 2020
Published date: July 2020
Keywords: Minor neurological signs, Neonatal hypoxic ischaemic encephalopathy (HIE), Neurodevelopmental, Neuromotor, Therapeutic hypothermia

Identifiers

Local EPrints ID: 439380
URI: http://eprints.soton.ac.uk/id/eprint/439380
ISSN: 1090-3798
PURE UUID: 20e6f287-6a43-4245-9c61-55c779eb3a7a
ORCID for Rina Cianfaglione: ORCID iD orcid.org/0000-0001-8739-0598
ORCID for Brigitte Vollmer: ORCID iD orcid.org/0000-0003-4088-5336

Catalogue record

Date deposited: 21 Apr 2020 16:30
Last modified: 26 Nov 2021 05:55

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Contributors

Author: Caroline Edmonds
Author: Suzannah K. Helps
Author: Hart Denise
Author: Anna Zatorska

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