Abstract
Objective
Identifying term infants presenting with early mild neonatal encephalopathy (NE) as candidates for therapeutic hypothermia (TH) remains unclear. Study objectives were to characterize the neonatal clinical, magnetic resonance imaging (MRI), and longer-term outcome in infants with mild NE treated with TH.
Study design
Retrospective cohort study of infants admitted with mild or moderate NE treated with TH. Enrollment criteria included a sentinel event, severe acidosis, DR interventions, and low Apgar scores.
Results
Infants with mild (n = 11) and moderate NE (n = 37) received TH. Mild NE findings included hyperalertness (64%), hypotonia (73%), high level sensory response (91%); 64% progressed to moderate NE. Infants with mild vs. moderate NE had less severe MRI changes (0 vs. 16%) and no cerebral palsy (CP) (0 vs. 13%).
Conclusions
Outcomes were favorable with mild NE whereas four infants with moderate NE developed CP. A potential role for TH in this population requires further study.
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LP and RR conceptualized and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. GR carried out the initial analyses, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. JP conceptualized and designed the study, designed the data collection instruments, coordinated and supervised data collection, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.
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Perretta, L., Reed, R., Ross, G. et al. Is there a role for therapeutic hypothermia administration in term infants with mild neonatal encephalopathy?. J Perinatol 40, 522–529 (2020). https://doi.org/10.1038/s41372-019-0562-z
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DOI: https://doi.org/10.1038/s41372-019-0562-z
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