Korean J Perinatol.  2015 Sep;26(3):208-214. 10.14734/kjp.2015.26.3.208.

Prediction of Neurodevelopmental Outcome in Hypoxic Ischemic Encephalopathy at 12 Months: Correlation of Brain MRI and EEG

Affiliations
  • 1Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea. neopedlee@gmail.com

Abstract

PURPOSE
The aims of this study were to estimate the neurodevelopmental outcome of hypoxic-ischemic encephalopathy (HIE) at 12 months, and determine the usefulness of brain magnetic resonance imaging (MRI) and electroencephalography (EEG) to predict neurodevelopmental outcome in term infants with HIE at 12 months.
METHODS
This study was conducted retrospectively on term infants with HIE from January 2009 to June 2013. Based on neurodevelopmental outcome at 12 months, infants were categorized into 2 groups. Brain MRI and EEG findings were stratified into 4 categories as normal, mild, moderate and severe groups.
RESULTS
Total 42 term infants were enrolled. Fifty seven point one percent (24/42) of total infants had favorable neurodevelopmental outcome at 12 months (favorable outcome, n=24). Thirty eight point one percent (16/42) of total infants had significant neurodevelopmental deficit at 12 months of age, and 4.8% (2/42) had mortality within 12 months (poor outcome, n=18). In brain MRI and EEG findings, there were significant correlations with neurodevelopmental outcome. Brain MRI showed sensitivity of 88.9%, specificity of 70.8%, positive predictive value of 69.6% and negative predictive value of 89.5%, while EEG showed sensitivity of 70.6%, specificity of 82.6%, positive predictive value of 75%, and negative predictive value of 79.2%. In the multivariate analysis, moderate-to-severe findings in brain MRI were the strongest risk factor (odds-ratio, 11.24; 95% confidence interval, 1.36-92.89; P=0.025).
CONCLUSION
Forty two point nine percent of total infants had poor neurodevelopmental outcome at 12 months. Brain MRI and EEG findings were correlated with neurodevelopmental outcome of term infants with HIE at 12 months.

Keyword

Asphyxia; Hypoxic ischemic encephalopathy; Developmental delay; Magnetic resonance imaging; Electroencephalography

MeSH Terms

Asphyxia
Brain*
Electroencephalography*
Humans
Hypoxia-Ischemia, Brain*
Infant
Magnetic Resonance Imaging*
Mortality
Multivariate Analysis
Retrospective Studies
Risk Factors
Sensitivity and Specificity

Reference

References

1. Volpe JJ. Perinatal brain injury: from pathogenesis to neuroprotection. Ment Retard Dev Disabil Res Rev. 2001; 7:56–64.
Article
2. Cotten CM, Shankaran S. Hypothermia for hypoxicischemic encephalopathy. Expert Rev Obstet Gynecol. 2010; 5:227–39.
Article
3. Badr Zahr LK, Purdy I. Brain injury in the infant: the old, the new, and the uncertain. J Perinat Neonatal Nurs. 2006; 20:16375.
4. Vannucci RC, Perlman JM. Interventions for perinatal hypoxic-ischemic encephalopathy. Pediatrics. 1997; 100:100414.
Article
5. Polat M, Simsek A, Tansug N, Sezer RG, Ozkol M, Baspinar P, et al. Prediction of neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy. Eur J Paediatr Neurol. 2013; 17:288–93.
Article
6. Jose A, Matthai J, Paul S. Correlation of EEG, CT, and MRI brain with neurological outcome at 12 months in term newborns with hypoxic ischemic encephalopathy. J Clin Neonatol. 2013; 2:125–30.
Article
7. Ong LC, Kanaheswari Y, Chandran V, Rohana J, Yong SC, Boo NY. The usefulness of early ultrasonography, electroencephalography and clinical parameters in predicting adverse outcomes in asphyxiated term infants. Singapore Med J. 2009; 50:705–9.
8. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976; 33:696–705.
9. Barkovich AJ, Hajnal BL, Vigneron D, Sola A, Partridge JC, Allen F, et al. Prediction of neuromotor outcome in perinatal asphyxia: evaluation of MR scoring systems. Am J Neuroradiol. 1998; 19:143–9.
10. Holmes GL, Lombroso CT. Prognostic value of background patterns in the neonatal EEG. J Clin Neurophysiol. 1993; 10:323–52.
Article
11. Laroia N, Guillet R, Burchfiel J, McBride MC. EEG background as predictor of electrographic seizures in high-risk neonates. Epilepsia. 1998; 39:545–51.
Article
12. Selton D, Andre M. Prognosis of hypoxic-ischaemic encephalopathy in fullterm newborns–value of neonatal electroencephalography. Neuropediatrics. 1997; 28:276–80.
13. Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. The Denver II: a major revision and restandardization of the Denver Developmental Screening Test. Pediatrics. 1992; 89:91–7.
Article
14. Bayley N. Bayley Scales of Infant Development. 2nd ed.San Antonio (TX): Psychological Corpration;1993.
15. Dixon G, Badawi N, Kurinczuk JJ, Keogh JM, Silburn SR, Zubrick SR, et al. Early developmental outcomes after newborn encephalopathy. Pediatrics. 2002; 109:26–33.
Article
16. Shah PS, Beyene J, To T, Ohlsson A, Perlman M. Postasphyxial hypoxic-ischemic encephalopathy in neonates: outcome prediction rule within 4 hours of birth. Arch Pediatr Adolesc Med. 2006; 160:729–36.
17. Sinclair DB, Campbell M, Byrne P, Prasertsom W, Robertson CM. EEG and longterm outcome of term infants with neonatal hypoxic-ischemic encephalopathy. Clin Neurophysiol. 1999; 110:655–9.
Article
18. Biagioni E, Mercuri E, Rutherford M, Cowan F, Azzopardi D, Frisone MF, et al. Combined use of electroencephalogram and magnetic resonance imaging in fullterm neonates with acute encephalopathy. Pediatrics. 2001; 107:461–8.
Article
19. El-Ayouty M, Abdel-Hady H, El-Mogy S, Zaghlol H, El-Beltagy M, Aly H. Relationship between electroencephalography and magnetic resonance imaging findings after hypoxic-ischemic encephalopathy at term. Am J Perinatol. 2007; 24:467–73.
Article
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