Newborns Referred for Therapeutic Hypothermia: Association between Initial Degree of Encephalopathy and Severity of Brain Injury (What About the Newborns with Mild Encephalopathy on Admission?)

Maude Gagne-Loranger; Megan Sheppard; Nabeel Ali; Christine Saint-Martin; Pia Wintermark

doi:10.1055/s-0035-1563712

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(02): 195-202
DOI: 10.1055/s-0035-1563712

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Newborns Referred for Therapeutic Hypothermia: Association between Initial Degree of Encephalopathy and Severity of Brain Injury (What About the Newborns with Mild Encephalopathy on Admission?)

Authors

Maude Gagne-Loranger

¹Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada
Megan Sheppard

¹Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada
Nabeel Ali

²Division of Newborn Medicine, Department of Pediatrics, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Canada
Christine Saint-Martin

³Department of Radiology, Montreal Children's Hospital, McGill University, Montreal, Canada
Pia Wintermark

¹Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada

Abstract

Objective The aim of this article was to describe the severity of brain injury and/or mortality in a cohort of newborns referred for therapeutic hypothermia, in relation to the degree of encephalopathy on admission, and to especially look at the ones with initial mild encephalopathy.

Study Design Term newborns with perinatal depression referred to our neonatal intensive care unit for possible hypothermia treatment from 2008 to 2012 were enrolled prospectively. The modified Sarnat score on admission was correlated with severity of brain injury on brain imaging and/or autopsy.

Results A total of 215 newborns were referred for possible cooling. Sixty percent (128/215) were cooled. Most of the not-cooled newborns with an available brain magnetic resonance imaging (85% = 50/59) had an initial mild encephalopathy, and 40% (20/50) developed brain injury. Some cooled newborns had an initial mild encephalopathy (12% = 13/108); only 31% (4/13) developed brain injury.

Conclusion Our results demonstrated that several newborns with an initial mild encephalopathy developed subsequent brain injury, especially when they were not cooled.

Keywords

asphyxiated newborns - neonatal encephalopathy - magnetic resonance imaging - brain injury

Full Text

References

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