Magnetic Resonance Biomarkers and Neurological Outcome of Infants with Mild Hypoxic-Ischaemic Encephalopathy Who Progress to Moderate Hypoxic-Ischaemic Encephalopathy.


Journal

Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577

Informations de publication

Date de publication:
2023
Historique:
received: 09 06 2022
accepted: 30 10 2022
pubmed: 23 12 2022
medline: 7 3 2023
entrez: 22 12 2022
Statut: ppublish

Résumé

There is increasing concern that infants with mild hypoxic-ischaemic encephalopathy (HIE) may develop seizures and progress to moderate HIE beyond the therapeutic window for cooling. The aim of this study was to examine the effect of therapeutic hypothermia on magnetic resonance imaging (MRI) biomarkers and neurological outcomes in infants with mild HIE and seizures within 24 h after birth. This study shows an observational cohort study on 366 (near)-term infants with mild HIE and normal amplitude-integrated electroencephalography background. Forty-one infants showed progression (11.2%); 29/41 (70.7%) were cooled. Infants with progression showed cerebral metabolite perturbations and higher white matter injury scores compared to those without in both cooled and non-cooled groups (p = 0.001, p = 0.02). Abnormal outcomes were seen in 5/12 (42%) non-cooled and 7/29 (24%) cooled infants with progression (p = 0.26). Early biomarkers are needed to identify infants with mild HIE at risk of progression. Mild HIE infants with progression showed a higher incidence of brain injury and abnormal outcomes.

Sections du résumé

BACKGROUND
There is increasing concern that infants with mild hypoxic-ischaemic encephalopathy (HIE) may develop seizures and progress to moderate HIE beyond the therapeutic window for cooling.
OBJECTIVE
The aim of this study was to examine the effect of therapeutic hypothermia on magnetic resonance imaging (MRI) biomarkers and neurological outcomes in infants with mild HIE and seizures within 24 h after birth.
METHODS
This study shows an observational cohort study on 366 (near)-term infants with mild HIE and normal amplitude-integrated electroencephalography background.
RESULTS
Forty-one infants showed progression (11.2%); 29/41 (70.7%) were cooled. Infants with progression showed cerebral metabolite perturbations and higher white matter injury scores compared to those without in both cooled and non-cooled groups (p = 0.001, p = 0.02). Abnormal outcomes were seen in 5/12 (42%) non-cooled and 7/29 (24%) cooled infants with progression (p = 0.26).
CONCLUSIONS
Early biomarkers are needed to identify infants with mild HIE at risk of progression. Mild HIE infants with progression showed a higher incidence of brain injury and abnormal outcomes.

Identifiants

pubmed: 36549280
pii: 000527871
doi: 10.1159/000527871
doi:

Substances chimiques

Biomarkers 0

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

153-160

Informations de copyright

© 2022 The Author(s). Published by S. Karger AG, Basel.

Auteurs

Paolo Montaldo (P)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
Department of Brain Sciences, Centre for Perinatal Neuroscience, Imperial College London, London, UK.

Simona Puzone (S)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Elisabetta Caredda (E)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Francesca Galdo (F)

Neonatal Intensive Care Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.

Umberto Pugliese (U)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Anna Maietta (A)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Serena Ascione (S)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Mario Diplomatico (M)

Neonatal Intensive Care Unit, AORN San Giuseppe Moscati, Avellino, Italy.

Ferdinando Spagnuolo (F)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Vincenzina Roma (V)

Department of Neonatology and NICU Pineta Grande Hospital, Castel Volturno, Italy.

Massimiliano De Vivo (M)

Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.

Mauro Carpentieri (M)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Sabino Moschella (S)

Neonatal Intensive Care Unit, AORN San Giuseppe Moscati, Avellino, Italy.

Lucio Giordano (L)

Department of Neonatology and NICU Pineta Grande Hospital, Castel Volturno, Italy.

Alessandra D'Amico (A)

Department of Radiology, "Tortorella" Private Hospital, Salerno, Italy.

Carlo Capristo (C)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Laura Travan (L)

Neonatal Intensive Care Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.

Giovanni Chello (G)

Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.

Emanuele Miraglia Del Giudice (E)

Department of Neonatal Intensive Care, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Mario Cirillo (M)

Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, University of Campania Luigi Vanvitelli, Naples, Italy.

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