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Am J Perinatol 2022; 39(15): 1678-1681
DOI: 10.1055/s-0041-1725161
Original Article

Electroencephalogram Background Predicts Time to Full Oral Feedings in Hypoxic–Ischemic Encephalopathy

Authors

  • Mrinmayee Takle

    1   Children's National Hospital Child Neurology Residency Program, Washington, District of Columbia

  • Mark Conaway

    2   Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia

  • Jennifer Burnsed 

    3   Department of Pediatrics, University of Virginia, Charlottesville, Virginia
    4   Department of Neurology, University of Virginia, Charlottesville, Virginia

Funding None.
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Abstract

Objective Infants with a history of neonatal hypoxic-ischemic encephalopathy (HIE) are at risk for oral motor dysfunction. Previous studies have associated the need for gastrostomy tube at neonatal intensive care unit discharge with brainstem injury on magnetic resonance imaging (MRI). However, the factors associated with time to full oral feeds in this population have not been previously described. This study aimed to study factors associated with time to full oral feeds in this population.

Study Design This is a single-center, retrospective study that examined these factors using Cox regression.

Results A total of 150 infants who received therapeutic hypothermia from 2011 to 2017 were included in this study. The single clinical factor significantly associated with time to full oral feeds was the severity of background abnormality on electroencephalogram in the first 24 hours of age (severe vs. mild 95% confidence interval [CI]: 0.34–0.74; moderate vs. mild 95% CI: 0.19–0.45). Brainstem injury on MRI was the factor most highly associated with need for gastrostomy tube placement (p = 0.028), though the overall incidence of need for gastrostomy tube feeds in this population was low (5%).

Conclusion These findings may help clinicians counsel families on what to expect in neonates with HIE and make decisions on the need for and timing to pursue gastrostomy tube in this population.

Key Points

  • The overall incidence of the need for assisted feeding at NICU discharge is low in this population.

  • MRI brainstem injury was most highly associated with need for gastrostomy tube placement.

  • Worsening severity of background abnormality on EEG was associated with longer time to oral feeds.

Keywords

neonate - hypoxia–ischemia - hypoxic–ischemic encephalopathy - oral feeding


Publication History

Received: 17 July 2020

Accepted: 25 January 2021

Article published online:
03 March 2021

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