Document Detail


Hypoxic-ischemic encephalopathy in preterm infants: antecedent factors, brain imaging, and outcome.
MedLine Citation:
PMID:  19390490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 =36 wk, Apgar scores <5/<7 at 1/5 min, major resuscitation at birth, and a brain MRI <6 postnatal wk. At least one additional criterion was required of the following: abnormal intrapartum CTG, sentinel event, meconium, cord pH <7.0, neonatal seizures, and multiorgan failure. Antenatal and perinatal data and > 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.
Authors:
Pavithra Logitharajah; Mary A Rutherford; Frances M Cowan
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  66     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-10-14     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Brain / pathology*
Developmental Disabilities / etiology,  physiopathology
Diagnostic Imaging
Female
Gestational Age
Humans
Hypoxia-Ischemia, Brain* / etiology,  pathology,  physiopathology
Infant, Newborn
Infant, Premature*
Magnetic Resonance Imaging
Male
Pregnancy
Pregnancy Outcome
Grant Support
ID/Acronym/Agency:
MC_U120081323//Medical Research Council; MC_U120088465//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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