Abstract:
BACKGROUND. Neonatal hypoxic ischaemic encephalopathy (NHIE) is an important cause of long-term handicap in survivors. There is
limited information on the burden of handicap from NHIE in sub-Saharan Africa.
OBJECTIVES. To determine the developmental outcomes in survivors of NHIE in South Africa (SA).
METHODS. In this prospective observational study, the developmental outcomes in 84 infants who had survived hypoxic ischaemic
encephalopathy (the NHIE group) were compared with those in 64 unaffected infants (the control group). The Bayley Scales of Infant
Development version III were used for assessment of developmental outcomes.
RESULTS. Significant differences were found between the developmental outcomes of the two groups, with a significantly lower composite
language score and higher proportions with language, motor and cognitive developmental delays in the NHIE group than in the control
group. Cerebral palsy (CP) was present in 13 of the infants with NHIE (15.5%) and none in the control group (p<0.001). CP was associated
with developmental delay, and also with the severity of NHIE. Therapeutic hypothermia (TH) was administered in 58.3% of the study group,
but although it was associated with lower rates of CP and developmental delay than in the group without TH, the only significant difference
was for delay on the language subscale.
CONCLUSIONS. Survivors of NHIE in SA are at risk of poor developmental outcomes.
