Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia

J Paediatr Child Health. 2000 Aug;36(4):363-9. doi: 10.1046/j.1440-1754.2000.00518.x.


Objectives: To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

Methodology: This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age.

Results: Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic-ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor.

Conclusions: Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apgar Score
  • Asphyxia Neonatorum / mortality*
  • Asphyxia Neonatorum / physiopathology*
  • Brain / physiopathology*
  • Cohort Studies
  • Echoencephalography*
  • Female
  • Fetal Distress / diagnosis
  • Humans
  • Infant, Newborn
  • Male
  • Prevalence
  • Prospective Studies
  • Survival Rate
  • Time Factors