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A prospective observational study of developmental outcomes in survivors of neonatal hypoxic ischaemic encephalopathy in South Africa

D E Ballot, D Rakotsoane, P A Cooper, T D Ramdin, T Chirwa, M S Pepper

Abstract


Background. Neonatal hypoxic ischaemic encephalopathy (NHIE) is an important cause of long-term handicap in survivors. There is limited information on the burden of handicap from NHIE in sub-Saharan Africa.

Objectives. To determine the developmental outcomes in survivors of NHIE in South Africa (SA).

Methods. In this prospective observational study, the developmental outcomes in 84 infants who had survived hypoxic ischaemic encephalopathy (the NHIE group) were compared with those in 64 unaffected infants (the control group). The Bayley Scales of Infant Development version III were used for assessment of developmental outcomes.

Results. Significant differences were found between the developmental outcomes of the two groups, with a significantly lower composite language score and higher proportions with language, motor and cognitive developmental delays in the NHIE group than in the control group. Cerebral palsy (CP) was present in 13 of the infants with NHIE (15.5%) and none in the control group (p<0.001). CP was associated with developmental delay, and also with the severity of NHIE. Therapeutic hypothermia (TH) was administered in 58.3% of the study group, but although it was associated with lower rates of CP and developmental delay than in the group without TH, the only significant difference was for delay on the language subscale.

Conclusions. Survivors of NHIE in SA are at risk of poor developmental outcomes.

 


Authors' affiliations

D E Ballot, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Neonatal Encephalopathy Suspected Hypoxic Ischaemic Encephalopathy (NESHIE) collaboration, South Africa

D Rakotsoane, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

P A Cooper, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

T D Ramdin, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Neonatal Encephalopathy Suspected Hypoxic Ischaemic Encephalopathy (NESHIE) collaboration, South Africa

T Chirwa, Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

M S Pepper, Neonatal Encephalopathy Suspected Hypoxic Ischaemic Encephalopathy (NESHIE) collaboration, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa

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Keywords

Neonatal hypoxic ischaemic encephalopathy; Infant development

Cite this article

South African Medical Journal 2020;110(4):308-312. DOI:10.7196/SAMJ.2020.v110i4.14311

Article History

Date submitted: 2020-03-30
Date published: 2020-03-30

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