Journal Article

PS-155Comparison Of Clinical And Electrophysiological Signs Of Encephalopathy In Neonates With Perinatal Asphyxia Qualifying For Hypothermia

van Haastert, IC, de Vries, LS, Sa-Couto, P, Toet, M C, Koopman-Esseboom, C, Groenendaal, F, Vilan, A

2014

Overview

Background and aimsEarly prediction of neurodevelopmental outcome following hypoxic-ischaemic encephalopathy remains a challenge. The aim of this retrospective study was to evaluate the aEEG background patterns and Thompson score on admission in asphyxiated neonates receiving hypothermia regarding outcome and neonatal variables.MethodsAfter excluding congenital malformations and muscle paralysis, 89 neonates (January 2008 to June 2012) were included (GA: 39.7 plus or minus 1.8 wks; BW: 3504 plus or minus 640 g). On admission the Thompson score and aEEG were recorded. aEEG was scored as Continuous Normal Voltage (CNV), Discontinuous Normal Voltage (DNV), Burst-Suppression (BS), Continuous Low Voltage (CLV) or Flat Trace (FT). The combination of one or more of the following event (s): death, cerebral palsy, and Griffiths DQ less than 85 at 18 months were considered an adverse outcome. ANOVA, correlation, and binary logistic regression analyses were performed.ResultsThompson scores (in mean plus or minus sd) were associated with aEEG pattern (CNV: 8.3 plus or minus 1.7; DNV: 8.9 plus or minus 1.9; BS: 11.6 plus or minus 3.6; CLV: 12.0 plus or minus 2.1; FT: 13.1 plus or minus 3.2; p < 0.001). Also, both aEEG and Thompson score were statistically correlated with Apgar 1 and 5 min scores (p < 0.05). Using a logistic regression model, both Thompson score (OR = 1.43; 95% CI = [1.15; 1.77]) and aEEG pattern (BS: OR = 4.06; 95% CI = [0.74; 22.16]; CLV: OR = 11.10; 95% CI = [1.38; 89.66]; FT: OR = 13.35; 95% CI = [1.87; 95.31]; reference group: CNV+DNV) were significant predictors of an adverse outcome.ConclusionsBoth Thompson scores and aEEG are associated with outcome in neonates receiving hypothermia for perinatal asphyxia and with 1 min Apgar scores. Further studies are needed to identify which method is preferable for selection of neonates for hypothermia.