Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement

Simple item page
dc.check.embargoformatNot applicableen
dc.check.infoNo embargo requireden
dc.check.opt-outNot applicableen
dc.check.reasonNo embargo requireden
dc.check.typeNo Embargo Required
dc.contributor.advisorMurray, Deirdre M.en
dc.contributor.advisorBoylan, Geraldine B.en
dc.contributor.authorAhearne, Caroline E.
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2018-03-27T11:57:10Z
dc.date.available2018-03-27T11:57:10Z
dc.date.issued2016
dc.date.submitted2016
dc.description.abstractThe 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.sponsorshipHealth Research Board (CSA/2012/40)en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Version
dc.format.mimetypeapplication/pdfen
dc.identifier.citationAhearne, C. 2016. Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement. PhD Thesis, University College Cork.en
dc.identifier.urihttps://hdl.handle.net/10468/5700
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2016, Caroline Ahearne.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/en
dc.subjectNeurodevelopmenten
dc.subjectBiomarkersen
dc.subjectPerinatal asphyxiaen
dc.subjectNeonateen
dc.subjectCognitionen
dc.subjectTouch-screen technologyen
dc.subjectHypoxic-ischaemic encephalopathyen
dc.thesis.opt-outfalse
dc.titleNeurodevelopmental outcome in perinatal asphyxia: prediction and measurementen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoral Degree (Structured)en
dc.type.qualificationnamePhD (Medicine and Health)en
ucc.workflow.supervisord.murray@ucc.ie
Files
Original bundle
Now showing 1 - 2 of 2
Thumbnail Image
Name:
Abstract.pdf
Size:
119.56 KB
Format:
Adobe Portable Document Format
Description:
Abstract
Thumbnail Image
Name:
AhearneCE_PhD2017.pdf
Size:
9.62 MB
Format:
Adobe Portable Document Format
Description:
Full Text E-thesis
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
5.62 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Doctoral Theses
College of Medicine and Health - Doctoral Theses
Paediatrics & Child Health - Doctoral Theses