Short-term outcomes of newborns with perinatal acidemia who are not eligible for systemic hypothermia therapy

Tara L. Dupont, Lina F. Chalak, Michael C. Morriss, P. Jeannette Burchfield, Lucy Christie, Pablo J. Sánchez

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective: To determine short-term outcomes of infants who had perinatal acidemia and were evaluated for hypothermia therapy but did not qualify based on a standardized neurologic examination. Study design: Retrospective, single-site cohort study of inborn infants of ≥36 weeks gestation who had perinatal acidemia from October 2005-September 2008 and had a standardized neurologic examination performed by a certified neonatologist to assess eligibility for hypothermia therapy. An abnormal short-term nursery outcome was defined as death, seizures, brain magnetic resonance imaging consistent with hypoxic-ischemic encephalopathy, abnormal neurologic examination at discharge, gastrostomy tube feeding, or inability to nipple all feeds beyond the first week of age. Results: One hundred forty-four (0.3%) of 46 887 newborns with perinatal acidemia had a neurologic examination performed that was either normal (n = 29) or consistent with mild encephalopathy (1 or 2 abnormal categories; n = 60). Of the latter infants classified as having mild encephalopathy, 12 (20%) experienced an abnormal short-term outcome (feeding difficulties, n = 8; abnormal neurologic examination at discharge, n = 7; abnormal brain magnetic resonance imaging, n = 6; seizures, n = 5; gastrostomy, n = 1; or death, n = 1). Conclusions: Twenty percent of newborns with perinatal acidemia and a neurologic examination that revealed only mild encephalopathy had abnormal short-term outcomes that could be attributed to the encephalopathy. Adjunctive tools or biomarkers for optimal assessment of infants with fetal acidemia for hypothermia therapy are needed.

Original languageEnglish (US)
Pages (from-to)35-41
Number of pages7
JournalJournal of Pediatrics
Volume162
Issue number1
DOIs
StatePublished - Jan 2013

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Neurologic Examination
Hypothermia
Brain Diseases
Newborn Infant
Gastrostomy
Seizures
Therapeutics
Magnetic Resonance Imaging
Brain Hypoxia-Ischemia
Brain Death
Nipples
Nurseries
Enteral Nutrition
Cohort Studies
Retrospective Studies
Biomarkers
Pregnancy
Brain

Keywords

  • HIE
  • Hypoxic-ischemic encephalopathy
  • Magnetic resonance imaging
  • MRI
  • National Institute of Child Health and Human Development
  • Negative predictive value
  • Neonatal intensive care unit
  • Neonatal Research Network
  • NICHD
  • NICU
  • NPV
  • NRN
  • Parkland Memorial Hospital
  • PMH
  • Positive predictive value
  • PPV

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Short-term outcomes of newborns with perinatal acidemia who are not eligible for systemic hypothermia therapy. / Dupont, Tara L.; Chalak, Lina F.; Morriss, Michael C.; Burchfield, P. Jeannette; Christie, Lucy; Sánchez, Pablo J.

In: Journal of Pediatrics, Vol. 162, No. 1, 01.2013, p. 35-41.

Research output: Contribution to journalArticle

Dupont, Tara L. ; Chalak, Lina F. ; Morriss, Michael C. ; Burchfield, P. Jeannette ; Christie, Lucy ; Sánchez, Pablo J. / Short-term outcomes of newborns with perinatal acidemia who are not eligible for systemic hypothermia therapy. In: Journal of Pediatrics. 2013 ; Vol. 162, No. 1. pp. 35-41.
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abstract = "Objective: To determine short-term outcomes of infants who had perinatal acidemia and were evaluated for hypothermia therapy but did not qualify based on a standardized neurologic examination. Study design: Retrospective, single-site cohort study of inborn infants of ≥36 weeks gestation who had perinatal acidemia from October 2005-September 2008 and had a standardized neurologic examination performed by a certified neonatologist to assess eligibility for hypothermia therapy. An abnormal short-term nursery outcome was defined as death, seizures, brain magnetic resonance imaging consistent with hypoxic-ischemic encephalopathy, abnormal neurologic examination at discharge, gastrostomy tube feeding, or inability to nipple all feeds beyond the first week of age. Results: One hundred forty-four (0.3{\%}) of 46 887 newborns with perinatal acidemia had a neurologic examination performed that was either normal (n = 29) or consistent with mild encephalopathy (1 or 2 abnormal categories; n = 60). Of the latter infants classified as having mild encephalopathy, 12 (20{\%}) experienced an abnormal short-term outcome (feeding difficulties, n = 8; abnormal neurologic examination at discharge, n = 7; abnormal brain magnetic resonance imaging, n = 6; seizures, n = 5; gastrostomy, n = 1; or death, n = 1). Conclusions: Twenty percent of newborns with perinatal acidemia and a neurologic examination that revealed only mild encephalopathy had abnormal short-term outcomes that could be attributed to the encephalopathy. Adjunctive tools or biomarkers for optimal assessment of infants with fetal acidemia for hypothermia therapy are needed.",
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AB - Objective: To determine short-term outcomes of infants who had perinatal acidemia and were evaluated for hypothermia therapy but did not qualify based on a standardized neurologic examination. Study design: Retrospective, single-site cohort study of inborn infants of ≥36 weeks gestation who had perinatal acidemia from October 2005-September 2008 and had a standardized neurologic examination performed by a certified neonatologist to assess eligibility for hypothermia therapy. An abnormal short-term nursery outcome was defined as death, seizures, brain magnetic resonance imaging consistent with hypoxic-ischemic encephalopathy, abnormal neurologic examination at discharge, gastrostomy tube feeding, or inability to nipple all feeds beyond the first week of age. Results: One hundred forty-four (0.3%) of 46 887 newborns with perinatal acidemia had a neurologic examination performed that was either normal (n = 29) or consistent with mild encephalopathy (1 or 2 abnormal categories; n = 60). Of the latter infants classified as having mild encephalopathy, 12 (20%) experienced an abnormal short-term outcome (feeding difficulties, n = 8; abnormal neurologic examination at discharge, n = 7; abnormal brain magnetic resonance imaging, n = 6; seizures, n = 5; gastrostomy, n = 1; or death, n = 1). Conclusions: Twenty percent of newborns with perinatal acidemia and a neurologic examination that revealed only mild encephalopathy had abnormal short-term outcomes that could be attributed to the encephalopathy. Adjunctive tools or biomarkers for optimal assessment of infants with fetal acidemia for hypothermia therapy are needed.

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