Acta Paediatr 2019 Apr 19. Epub 2019 Apr 19.
Department of Neonatal Medicine, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Aim: To evaluate long-term cognitive and behavioural outcomes of children with neonatal hypoxic-ischaemic encephalopathy in the absence of cerebral palsy.
Methods: A systematic search was performed on five databases (EMBASE, Medline, PubMed, Web of Science, PsycInfo). Randomised-controlled trials, non-randomised controlled trials, or observational studies, published between 1990-2017, that reported long-term (age ≥ 4 years) cognitive and/or behavioural outcomes of neonatal hypoxic-ischaemic encephalopathy without cerebral palsy were included.
Results: Seven articles met the inclusion criteria (n=352 total participants, n=53 treated with therapeutic hypothermia). Studies reporting cognitive outcome demonstrate impairment of general cognitive abilities in 25-63% of participants with hypoxic-ischaemic encephalopathy without cerebral palsy. Specific cognitive difficulties were reported in two studies for attention, executive functioning, memory function, and language. Results regarding behavioural outcome possibly indicate a higher risk of difficulties.
Conclusion: A substantial proportion of children with neonatal HIE who survive without cerebral palsy are at increased risk of general and/or specific cognitive impairments. Behavioural problems may be more common, but evidence is limited. Results highlight the importance of comprehensive long-term follow-up to identity difficulties and enable intervention to optimise educational achievement and behavioural adjustment. This article is protected by copyright. All rights reserved.