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 language | English (US) |
---|---|
Pages (from-to) | 35-41 |
Number of pages | 7 |
Journal | Journal of Pediatrics |
Volume | 162 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2013 |
Keywords
- HIE
- Hypoxic-ischemic encephalopathy
- MRI
- Magnetic resonance imaging
- NICHD
- NICU
- NPV
- NRN
- National Institute of Child Health and Human Development
- Negative predictive value
- Neonatal Research Network
- Neonatal intensive care unit
- PMH
- PPV
- Parkland Memorial Hospital
- Positive predictive value
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health