Mild hypoxic ischaemic encephalopathy and long term neurodevelopmental outcome - A systematic review

• Published in: Early human development Vol. 120; pp. 80 - 87
• Main Authors: Conway, J.M., Walsh, B.H., Boylan, G.B., Murray, D.M.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2018
• Subjects: Brain Diseases - physiopathology; Brain Diseases - therapy; Developmental Disabilities - etiology; Humans; Hypothermia, Induced - methods; Hypoxia-Ischemia, Brain - physiopathology; Hypoxia-Ischemia, Brain - therapy; Hypoxic ischaemic encephalopathy (HIE); Infant, Newborn; Infant, Newborn, Diseases - physiopathology; Infant, Newborn, Diseases - therapy; Neurodevelopmental outcome; Therapeutic hypothermia (TH); Treatment Outcome; Neurodevelopmental outcome; Hypoxic ischaemic encephalopathy (HIE); Therapeutic hypothermia (TH)
• ISSN: 0378-3782; 1872-6232; 1872-6232
• DOI: 10.1016/j.earlhumdev.2018.02.007

Hypoxic ischaemic encephalopathy (HIE) remains a significant cause of long term neurodisability despite therapeutic hypothermia (TH). Infants with mild HIE, representing 50% of those with HIE, are perceived as low risk and are currently not eligible for TH [1]. This review examines the available evidence of outcome in term infants with mild HIE. Medline, Embase and Cochrane Clinical Trials databases were searched in March 2017. Studies with well-defined HIE grading at birth and standardised neurodevelopmental assessment at ≥18 months were included. Abnormal outcome was defined as death, cerebral palsy or standardised neurodevelopmental test score more than 1 standard deviation below the mean. Twenty studies were included. Abnormal outcome was reported in 86/341 (25%) of infants. There was insufficient evidence to examine the effect of TH on outcome. A significant proportion of infants with mild HIE have abnormal outcome at follow up.