Hypoxic-Ischemic Encephalopathy in Preterm Infants: Antecedent Factors, Brain Imaging, and Outcome
Pediatric ResearchPublished 15 July 2009
Pavithra Logitharajah, Mary Rutherford, Frances M. Cowan
Citations163
SJR quartileQ1
SJR score1.17
SNIP1.29
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TL;DR
Early MRI is feasible and a valuable tool in this poorly reported group of infants with hypoxic-ischemic encephalopathy and allowed accurate prediction of neurodevelopmental outcome.
Abstract
Our objectives were to establish antecedent factors and patterns of brain injury and their prognostic value in preterm infants with hypoxic-ischemic encephalopathy (HIE). Essential inclusion criteria were gestation (GA) or =2 y neurodevelopmental outcome were documented. Fifty-five infants (GA 26-36; median, 35 wk) were eligible; all had 1-6 (median, 3) additional criteria. Placental abruption was the commonest identifiable antecedent event. Evidence of infection was not prominent. Main sites of injury were basal ganglia (BG, 75%), mostly severe, white matter (WM, 89%), mostly mild, brainstem (44%), and cortex (58%). Brainstem injury was associated with severe BG, WM, and cortical injury. Two-year outcome: death (32%), cerebral palsy (26%, mostly severe quadriplegia), mild impairment (10%), and normal (32%). Significant central gray matter and brainstem injury was found in many preterm infants with HIE. Neonatal MRI findings allowed accurate prediction of neurodevelopmental outcome. Early MRI is feasible and a valuable tool in this poorly reported group of infants.
Keywords
Medicine
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