Gender and age related adverse effects of child’s hypoxic-ischemic encephalopathy

Authors

  • O.S. Yablon National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Ukraine https://orcid.org/0000-0001-9860-7588
  • T.V. Bondarenko National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Ukraine

DOI:

https://doi.org/10.15574/SP.2022.121.5

Keywords:

hypoxic-ischemic encephalopathy, disability, cerebral palsy, episyndrome, gender differences

Abstract

Introduction. Among the causes of childhood disability, the consequences of hypoxic-ischemic encephalopathy (HIE) transmitted in the neonatal period are the most significant. Annually in developed countries, 1-8 neonates per 1,000 are diagnosed with HIE. The incidence rate is twice as high in low- and middle-income countries. Among them, every 4th child with this diagnosis has adverse consequences of the disease sort of severe neurological pathologies such as epilepsy and cerebral palsy (CP). Researchers are particularly interested in the easy course of HIE and the ability to predict its consequences.

Aim of the research. To establish the gender and age characteristics of the adverse effects of HIE in preschool children.

Materials and methods. The study is prospective, carried out on all its stages in the neonatology center and the center of follow-up observation of Vinnytsia Regional Children's Clinical Hospital VOR, 214 children aged 0 to 6 years were examined. The prospective study included 174 children born full-term and in the neonatal period suffered HIE of various severity.

Results. The results of follow-up were analyzed at 1, 3 and 6 years. The formation of disability had gender and age related features. Thus, among 23 children with disabilities, boys predominated - 16 (69.57%). With age, the number of children with disabilities increased from 14 (9.52%) in 1 year to 23 (15, 65%) in 3 years and remained unchanged at the age of 6 years. More than half of children had mental and language retardation at the age of 1. Thus, among 23 children with disabilities, boys predominated - 16 (69.57%). With age, the number of children with disabilities increased from 14 (9.52%) at 1 year of age to 23 (15.65%) among 3-agers and remained unchanged among 6-agers. More than half of children had mental and language retardation at the age of 1. As they reached the age of 6, their number decreased to 25% girls and 41.2% boys. Certainly, majority of these children were among patients with severe GIE in the neonatal period. 20 (13.61%) children had episyndrome at the age of 1 year, 11 (55.0%) of them - prevailing boys. For the children aged 3 with slight and moderate HIE, the diagnosis was disaffirmed. Among 6-olders with spasms boys prevailed. At the age of 6 years among children with convulsions significantly prevailed boys 12 (63.16%). Among concomitant pathologies of children with HIE consequences there prevailed anemia at the age of 3 years, found in 1 of 4 girls and 1 of 5 boys severe HIE history, ophthalmic diseases fou nd among 23.5% of boys in this group and bronchial asthma - among 9.52%. Child mortality with HIE in the neonatal period, in the first 6 years of life was 2.72%.

Conclusions. The formation of adverse effects of HIE in children had gender and age characteristics. Boys predominated among children with disabilities, they were more likely to have mental and language retardation and episyndrome. With age, the number of children with adverse effects has decreased, with the exception of the disabled, whose number has increased.

References

Aoki Y, Kono T, Enokizono M, Okazaki K. (2021). Short-term outcomes in infants with mild neonatal encephalopathy: a retrospective, observational study. BMC pediatrics. 21(1): 224. https://doi.org/10.1186/s12887-021-02688-y; PMid:33962618 PMCid:PMC8103637

Bonifacio SL, Hutson S. (2021). The Term Newborn: Evaluation for Hypoxic-Ischemic Encephalopathy. Clinics in perinatology. 48(3): 681-695. https://doi.org/10.1016/j.clp.2021.05.014; PMid:34353587

Chalak LF, Nguyen KA, Prempunpong C, Heyne R, Thayyil S et al. (2018). Prospective research in infants with mild encephalopathy identified in the first six hours of life: neurodevelopmental outcomes at 18-22 months. Pediatric research. 84(6): 861-868. https://doi.org/10.1038/s41390-018-0174-x; PMid:30250303 PMCid:PMC6445543

Craig AK, McAllister LM, Evans S, Melendi ME. (2021). Telemedicine consults to assess neonatal encephalopathy are feasible in the neonatal intensive care unit. Journal of perinatology: official journal of the California Perinatal Association. 41(6): 1519-1521. https://doi.org/10.1038/s41372-020-00828-3; PMid:32958837 PMCid:PMC8593849

Di Salvo ML, Hargett SL, Jnah A, Newberry D. (2020). System Specific Effects of Therapeutic Hypothermia with Neonatal Encephalopathy: Pearls for Clinicians. Neonatal network: NN. 39(4): 205-214. https://doi.org/10.1891/0730-0832.39.4.205; PMid:32675316

El-Dib M, Parziale MP, Johnson L, Benson CB, Grant PE, Robinson J, Volpe JJ, Inder T. (2019). Encephalopathy in neonates with subgaleal hemorrhage is a key predictor of outcome. Pediatric research. 86(2): 234-241. https://doi.org/10.1038/s41390-019-0400-1; PMid:30999320

Enweronu-Laryea C, Martinello KA, Rose M, Manu S, Tann CJ, Meek J, Ahor-Essel K, Boylan GB, Robertson NJ. (2019). Core temperature after birth in babies with neonatal encephalopathy in a sub-Saharan African hospital setting. The Journal of physiology. 597(15): 4013-4024. https://doi.org/10.1113/JP277820; PMid:31168907 PMCid:PMC6767688

Fierman AH. (2019). Foreword: Update on the current management of newborns with neonatal encephalopathy. Current problems in pediatric and adolescent health care. 49(7): 100648. https://doi.org/10.1016/j.cppeds.2019.100648; PMid:31439416

Gonzalez FF. (2019). Neuroprotection Strategies for Term Encephalopathy. Seminars in pediatric neurology. 32: 100773. https://doi.org/10.1016/j.spen.2019.08.009; PMid:31813519 PMCid:PMC6934049

Grass B, Scheidegger S, Latal B, Hagmann C, Held U, Brotschi B, National Asphyxia and Cooling Register Group, Follow-up Group (2020). Short-term neurological improvement in neonates with hypoxic-ischemic encephalopathy predicts neurodevelopmental outcome at 18-24 months. Journal of perinatal medicine. 48(3): 296-303. https://doi.org/10.1515/jpm-2019-0391; PMid:32069247

Gunn AJ, Battin M. (2019). Towards faster studies of neonatal encephalopathy. The Lancet. Neurology. 18(1): 21-22. https://doi.org/10.1016/S1474-4422(18)30370-3

Martini S, Castellini L, Parladori R, Paoletti V, Aceti A, Corvaglia L. (2021). Free Radicals and Neonatal Brain Injury: From Underlying Pathophysiology to Antioxidant Treatment Perspectives. Antioxidants (Basel, Switzerland). 10(12): 2012. https://doi.org/10.3390/antiox10122012; PMid:34943115 PMCid:PMC8698308

Mcintyre S, Badawi N, Blair E, Nelson KB. (2015). Does aetiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy influence the outcome of treatment? Developmental medicine and child neurology. 57; Suppl 3: 2-7. https://doi.org/10.1111/dmcn.12725; PMid:25800486

Parmentier C, Steggerda SJ, Weeke LC, Rijken M, De Vries LS, Groenendaal F. (2021). Outcome of non-cooled asphyxiated infants with under-recognised or delayed-onset encephalopathy. Archives of disease in childhood. Fetal and neonatal edition, fetalneonatal. 2020: 321331. Advance online publication. https://doi.org/10.1136/archdischild-2020-321331; PMid:34916259

Penkov AYu. (2013). To the discussion of follow-up observation of newborns at risk. Neonatology, surgery and perinatal medicine. 3 (9): 133-137.

Pouppirt NR, Martin V, Pagnotto-Hammitt L, Spittle AJ, Flibotte J, DeMauro SB. (2021). The General Movements Assessment in Neonates With Hypoxic Ischemic Encephalopathy. Journal of child neurology. 36(8): 601-609. https://doi.org/10.1177/0883073820981515; PMid:33439066

Power BD, McGinley J, Sweetman D, Murphy J. (2019). The Modified Sarnat Score in the Assessment of Neonatal Encephalopathy: A Quality Improvement Initiative. Irish medical journal. 112(7): 976. https://doi.org/10.1136/archdischild-2019-epa.532

Prempunpong C, Chalak LF, Garfinkle J, Shah B, Kalra V et al. (2018). Prospective research on infants with mild encephalopathy: the PRIME study. Journal of perinatology: official journal of the California Perinatal Association. 38(1): 80-85. https://doi.org/10.1038/jp.2017.164; PMid:29095433 PMCid:PMC8592379

Rao P. (2021). Randomized Controlled Trial Evaluating Hypothermia for Neonatal Encephalopathy in Low- and Middle-Income Countries: Neonatologist's Viewpoint. Indian pediatrics. 58(10): 984-985. https://doi.org/10.1007/s13312-021-2335-y; PMid:34636328

Russ JB, Simmons R, Glass HC. (2021). Neonatal Encephalopathy: Beyond Hypoxic-Ischemic Encephalopathy. NeoReviews. 22(3): e148-e162. https://doi.org/10.1542/neo.22-3-e148; PMid:33649088

Sadler LC, Farquhar CM, Masson VL, Battin MR. (2016). Contributory factors and potentially avoidable neonatal encephalopathy associated with perinatal asphyxia. American journal of obstetrics and gynecology. 214(6): 747.e1-747.e7478. https://doi.org/10.1016/j.ajog.2015.12.037; PMid:26723195

Sadler LC, Masson, VL, Belgrave S, Bennett HF, van den Boom J, Miller S, Battin MR. (2019). Contributory factors and potentially avoidable neonatal encephalopathy associated with acute peripartum events: An observational study. The Australian & New Zealand journal of obstetrics & gynaecology. 59(5): 699-705. https://doi.org/10.1111/ajo.12957; PMid:30747459

Seesahai J, Luther M, Rhoden CC, Church PT, Asztalos E, Banihani R. (2020). The general movements assessment in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age: a scoping review protocol. Systematic reviews. 9(1): 154. https://doi.org/10.1186/s13643-020-01358-x; PMid:32622366 PMCid:PMC7335433

Shepherd E, Salam RA, Middleton P, Han S, Makrides M, McIntyre S, Badawi N, Crowther CA. (2018). Neonatal interventions for preventing cerebral palsy: an overview of Cochrane Systematic Reviews. The Cochrane database of systematic reviews. 6(6): CD012409. https://doi.org/10.1002/14651858.CD012409.pub2; PMid:29926474 PMCid:PMC6513209

Suppiej A, Vitaliti G, Talenti G, Cuteri V, Trevisanuto D, Fanaro S, Cainelli E. (2021). Prognostic Risk Factors for Severe Outcome in the Acute Phase of Neonatal Hypoxic-Ischemic Encephalopathy: A Prospective Cohort Study. Children (Basel, Switzerland). 8(12): 1103. https://doi.org/10.3390/children8121103; PMid:34943299 PMCid:PMC8700551

Surkov DM. (2018). Hypoxic-ischemic encephalopathy in full-term infants: risk factors and their impact on the acute period. Medicine of emergencies. 6: 86-92. URL: http://nbuv.gov.ua/UJRN/Medns_2018_6_17.

Wachtel EV, Verma S, Mally PV. (2019). Update on the current management of newborns with neonatal encephalopathy. Current problems in pediatric and adolescent health care. 49(7): 100636. https://doi.org/10.1016/j.cppeds.2019.07.001; PMid:31371100

Znamenska TK, Martyniuk VYu, Shveikina VB, Galagan VA, Bikshaeva YB, Shveikina KhI. (2021). Modern approach to diagnosis and treatment of seizures in newborns and early age children. Modern Pediatrics. Ukraine. 3(115): 37-50. https://doi.org/10.15574/SP.2021.116.56

Downloads

Published

2022-02-28

Issue

Section

Original articles