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Long-term outcomes following hypoxic-ischemic encephalopathy
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Date
2020-05
Authors
Halpin, Stephen
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Systematic Review Abstract - Aim: To determine the long-term school and psychosocial outcomes in survivors of mild and moderate hypoxic ischemic encephalopathy (HIE) without cerebral palsy (CP). Methods: A systematic review was conducted on five databases (Medline, PsycINFO, Embase, PubMed, and Cochrane Trials Database). All prospective and retrospective studies (randomised controlled trials, observational and case-controlled cohort in design), with a clear definition of HIE, where mild and moderate grade of HIE was explicitly stated, and that reported long-term school and psychosocial data were included. Results: Seven articles met the inclusion criteria (n = 405). Results indicated adverse school outcomes (e.g. attendance at special school, academic delay, and lower scores on standardised school performance tests) were associated with both mild and moderate HIE without CP, although impact was greatest for the moderate HIE cohorts. Similar associations were found for psychosocial outcomes (e.g. anxiety, social withdrawal, and inattention). Interpretation: Children of school-age with moderate HIE in infancy are at increased risk of adverse school outcomes as noted above, with some evidence of slightly elevated risk for mild HIE cases. These findings highlight the need for monitoring of children with HIE beyond infancy to identify academic needs and maximise their opportunities.
Empirical Study Abstract - Objective: Follow-up study of infants with mild-moderate hypoxic ischemic encephalopathy (HIE) into later childhood is sparse. The current controlled study sought to explore the neuropsychological and behavioural outcomes of adolescents with mild and moderate HIE. Methods: Adolescents with a history of mild-moderate HIE (n = 23), their siblings (n = 13), and healthy peers (n = 14) underwent neuropsychological assessment across key cognitive domains of functioning. Behavioural adjustment, school, and social competencies were also measured through both parental and youth report questionnaires. Results: No differences in neuropsychological and behavioural outcomes were observed between mild and moderate HIE cohorts. Adolescents with mild-moderate HIE at birth had significantly lower scores on tests of attention/executive functioning, verbal reasoning and sensory-motor ability compared to healthy peers, with moderate to large effect sizes. In terms of behavioural adjustment, parents reported elevated levels of peer problems only in the HIE group compared to both siblings and healthy controls. Conclusions: The data indicated some evidence for neuropsychological deficits and behavioural difficulties in adolescents with mild-moderate HIE compared to healthy peers and siblings. This combination of deficits can result in distinct problems such as school attainment and there was evidence of such in this cohort. The absence of differences on some measures when compared to sibling controls -v- other healthy controls is discussed.
Description
Keywords
Hypoxic-ischemic encephalopathy , Long-term , School , Neuropsychological , Behavioural , Outcomes
Citation
Halpin, S. 2020. Long-term outcomes following hypoxic-ischemic encephalopathy. DClinPsych Thesis, University College Cork.