Neurological and perceptual-motor outcome at 5 - 6 years of age in children with neonatal encephalopathy: relationship with neonatal brain MRI

Neuropediatrics. 2002 Oct;33(5):242-8. doi: 10.1055/s-2002-36737.


Objective: The aims of this study were 1) to determine the incidence of minor neurological dysfunction and perceptual-motor difficulties in children aged 5-1/2 -- 6-1/2, who had been born full-term but presented with neonatal encephalopathy (NE) and low Apgar scores and 2) to examine the relationships between the presence/absence of these difficulties with neonatal brain MRI.

Participants and methods: Sixty-eight full-term infants with one minute Apgar scores less than or equal to 5 and neurological abnormalities during the first 48 hours after birth were included in the study. All children had a neonatal MRI brain scan. Surviving infants were assessed between the age of 5 and 6 years using the Touwen Examination, the Movement ABC and the WPPSI-R.

Results: Fifteen of the 68 infants (22 %) died in the neonatal period. Of the 53 surviving infants, 19 (36 %) had cerebral palsy. The remaining 34 were considered normal at 2 years of age but, when assessed at school age, 8 (15 %) had minor neurological dysfunction and/or perceptual-motor difficulties, 1 (2 %) had only cognitive impairment and 25 (47 %) were normal. The outcome largely reflected the pattern of lesions on brain imaging. While 83 % of those with a normal outcome had normal scans or minimal white matter lesions, 80 % of those with minor neurological dysfunction and/or perceptual-motor difficulties had mild or moderate basal ganglia or more marked white matter lesions.

Conclusion: Continued surveillance is recommended for children with apparently normal outcome at two years of age after NE, particularly when abnormalities are detected on brain MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Apgar Score
  • Brain Diseases / complications*
  • Brain Diseases / congenital*
  • Brain Diseases / pathology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Motor Neuron Disease / etiology*
  • Motor Neuron Disease / pathology
  • Motor Neuron Disease / physiopathology*
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / pathology
  • Nervous System Diseases / physiopathology*
  • Outcome Assessment, Health Care*
  • Perception / physiology*
  • Prospective Studies