Clin Exp Pediatr.
2021 Dec;64(12):608-618. 10.3345/cep.2021.00164.
Cognitive outcomes in late childhood and adolescence of neonatal hypoxic-ischemic encephalopathy
- Affiliations
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- 1Department of Pediatrics, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
- 2Department of Neurology and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- 3Department of Pediatrics, Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA, USA
- 4Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- KMID: 2522660
- DOI: http://doi.org/10.3345/cep.2021.00164
Abstract
- Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.
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