Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy

Am J Obstet Gynecol. 2004 Jan;190(1):93-9. doi: 10.1016/s0002-9378(03)00908-6.

Abstract

Objective: This study was undertaken to determine the value of a neonatal encephalopathy score (ES) and the presence of seizures for predicting 30-month neurodevelopmental outcome.

Study design: In a cohort study, 68 term newborn infants with encephalopathy were evaluated with an ES based on alertness, feeding, tone, respiratory status, reflexes, and seizure activity (range: 0-6). Seizures were noted as present or absent clinically. Significant cognitive deficits (Mental Development Index <70), motor disability (spastic triplegia/quadriplegia), or death were abnormal outcomes.

Results: Twenty-two newborn infants (32%) had abnormal outcomes. With the use of maximum ES and presence of seizures from days 1 to 3 of life, 87% of newborn infants were correctly classified (area under receiver operating curve 0.93). By using ES and presence of seizures on day 1 only, 87% of newborn infants were correctly classified (area under receiver operating curve 0.89).

Conclusion: The severity of neonatal encephalopathy and the presence of seizures are valuable predictors of 30-month neurodevelopmental outcome, as early as the first day of life.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aging*
  • Brain Diseases / complications
  • Brain Diseases / physiopathology*
  • Child Development*
  • Cohort Studies
  • Female
  • Humans
  • Infant, Newborn / growth & development*
  • Male
  • Nervous System / growth & development*
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Seizures / etiology
  • Seizures / physiopathology