Systematic Review: Long-term cognitive and behavioural outcomes of neonatal hypoxic-ischaemic encephalopathy in children without cerebral palsy.

Authors:
Mark J Johnson
Mark J Johnson
Princess Anne Hospital
United Kingdom

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.

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Source
http://dx.doi.org/10.1111/apa.14821DOI Listing
April 2019
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