Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement

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dc.contributor.advisor Murray, Deirdre M. en
dc.contributor.advisor Boylan, Geraldine B. en Ahearne, Caroline E. 2018-03-27T11:57:10Z 2018-03-27T11:57:10Z 2016 2016
dc.identifier.citation Ahearne, C. 2016. Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement. PhD Thesis, University College Cork. en
dc.description.abstract The aim of this thesis was to improve our ability to predict and measure neurodevelopmental outcome in early childhood with particular reference to high-risk infants with perinatal asphyxia. Methods: 1) Promising umbilical cord blood biomarkers were analysed for ability to predict performance in the Bayley Scales of Infant and Toddler Development (Edition 3) at three years. 2) A retrospective cohort was analysed for performance of a low-risk cohort on the Bayley-3 at two years and compared to standardised scores. 3) A survey asked parents to report prevalence and quality of touch-screen usage in their toddlers. 4) Pilot testing of a novel cognitive assessment tool, the“Babyscreen App”, was performed on a prospective low risk cohort. The Babyscreen App was administered alongside the Bayley-3 at age 18 months to 2 years. Results: 1) IL-16 predicted severe outcome with an area under the ROC curve of 0.83 (p= Levels ≥ 514 pg/mL predicted a severe outcome with a sensitivity of 83% and a specificity of 81%. 2 metabolite models were tested. Model A predicted abnormal outcome with an area under ROC curve of 0.77, p<0.01. Model B was robust to predict both severe outcome (area under ROC curve of 0.92, p<0.01) and intact survival (0.80, p=0.01). 2) 240 two year olds were analysed for performance on the Bayley-3. Language and fine motor scores were significantly higher compared to U.S standardised norms, 109 ± 13 v. 100 ± 15 , p<0.001, and 11.5 ± 2 v. 10 ± 3, p<0.001 respectively. 3) For the examination of touch-screen usage in toddlers, 82 questionnaires were completed by parents of typically developing children aged 12 to 36 months. 71% of toddlers included had access to touch-screen devices for a median (IQR) of 15 (9-26) minutes per day. By 24 months the majority of children were able to swipe, unlock and actively look for touch-screen features. 4) 95 children underwent administration of the Babyscreen App and the Bayley-3. Significant medium sized correlations occurred between various measures of app performance and cognitive composite scores on the Bayley-3. Combined measures of overall app performance could predict cognitive scores less than 90 (1SD below the mean of our cohort) with an area under the ROC curve of 0.69 (0.55-0.83), p=0.02. Conclusion: This thesis has shown that novel biomarkers measured in umbilical cord blood at birth can predict neuro developmental outcome and that a novel touch-screen application can assess cognition in toddlers. en
dc.description.sponsorship Health Research Board (CSA/2012/40) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2016, Caroline Ahearne. en
dc.rights.uri en
dc.subject Neurodevelopment en
dc.subject Biomarkers en
dc.subject Perinatal asphyxia en
dc.subject Neonate en
dc.subject Cognition en
dc.subject Touch-screen technology en
dc.subject Hypoxic-ischaemic encephalopathy en
dc.title Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral Degree (Structured) en
dc.type.qualificationname PhD (Medicine and Health) en
dc.internal.availability Full text available en No embargo required en
dc.description.version Accepted Version
dc.contributor.funder Health Research Board en
dc.description.status Not peer reviewed en Paediatrics and Child Health en
dc.check.type No Embargo Required
dc.check.reason No embargo required en
dc.check.opt-out Not applicable en
dc.thesis.opt-out false
dc.check.embargoformat Not applicable en
dc.internal.conferring Summer 2017 en

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© 2016, Caroline Ahearne. Except where otherwise noted, this item's license is described as © 2016, Caroline Ahearne.
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