Shankaran S, Laptook AR, McDonald SA, Hintz SR, Barnes PD, Das A. Patterns of neonatal hypoxic-ischaemic brain injury. Subacute hypoxia-ischemia and the timing of injury in treatment with therapeutic hypothermia. Neuroprotection with prolonged head cooling started before postischemic seizures in fetal sheep. Gunn AJ, Gunn TR, Gunning MI, Williams CE, Gluckman PD. Dramatic neuronal rescue with prolonged selective head cooling after ischemia in fetal lambs. Gunn AJ, Gunn TR, de Haan HH, Williams CE, Gluckman PD. Risk factors for neonatal hypoxic-ischemic encephalopathy in the absence of sentinel events. Novak CM, Eke AC, Ozen M, Burd I, Graham EM. Antepartum and intrapartum factors preceding neonatal hypoxic-ischemic encephalopathy. Martinez-Biarge M, Diez-Sebastian J, Wusthoff CJ, Mercuri E, Cowan FM. Perinatal morbidity and risk of hypoxic-ischemic encephalopathy associated with intrapartum sentinel events. Martinez-Biarge M, Madero R, González A, Quero J, García-Alix A. Antepartum and intrapartum risk factors for neonatal encephalopathy at term. Locatelli A, Incerti M, Paterlini G, Doria V, Consonni S, Provero C, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. 2011 165:692–700.īadawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O’Sullivan F, Burton PR, et al. Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial. Jacobs SE, Morley CJ, Inder TE, Stewart MJ, Smith KR, McNamara PJ, et al. Moderate hypothermia to treat perinatal asphyxial encephalopathy. 2005 353:1574–84.Īzzopardi DV, Strohm B, Edwards AD, Dyet L, Halliday HL, Juszczak E, et al. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al. Neonates with HIE receiving TH after PSE had less severe injury on brain MRI after rewarming, and improved motor and language outcomes at 18–36 months.
Injury on brain MRI despite TH after PSE was associated with unfavorable neurodevelopmental outcome ( p < 0.001). In PSE, favorable motor outcome persisted (OR for impairment 0.15 (0.003–0.84), p = 0.03) after adjusting for the degree of encephalopathy and brain MRI injury. PSE was associated with favorable motor ( p = 0.02), language outcome ( p = 0.03), and trend to better cognitive scores ( p = 0.13).
Neonates with PSE had more normal MRIs (76%) compared with neonates without PSE (55%), p = 0.01. Out of the 182 neonates, 53 (29%) neonates had PSE and 129 (71%) neonates did not have PSE. Data collection included perinatal history, brain MRI, and neurodevelopmental outcome. This is a retrospective single-center study. To study the association between perinatal sentinel events (PSE) and brain MRI/neurodevelopmental outcomes in neonates with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH).