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Functional status at 18 months of age as a predictor of childhood disability after neonatal hypoxic‐ischemic encephalopathy
Author(s) -
Natarajan Girija,
Shankaran Seetha,
Pappas Athina,
Bann Carla,
Tyson Jon E,
McDonald Scott,
Das Abhik,
Hintz Susan,
Vohr Betty,
Higgins Rosemary
Publication year - 2014
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12512
Subject(s) - hypoxic ischemic encephalopathy , encephalopathy , medicine , pediatrics , hypoxia (environmental) , cardiology , chemistry , organic chemistry , oxygen
Aim In children with neonatal hypoxic‐ischemic encephalopathy (HIE), we examined the association between 18‐month functional status by parental report and disability at 6‐7 years. Method Prospective observational study involving participants in the NICHD randomized controlled trial of hypothermia for HIE. Parent questionnaires‐Functional Status‐II (FS‐II), Impact on Family (IOF) and Family Resource Scale (FRS) at 18 months were correlated with 6‐ to 7‐year developmental assessments. Disability at 6‐7 years was defined as IQ < 70, gross motor functional classification scale level III‐V, bilateral blindness, deafness, or epilepsy. Results Rates of severe HIE (32 vs. 15%), public insurance (73% vs. 47%) and IOF scales were higher and mean (SD) FS‐II independence (I) {54 (SD 35) vs. 98 (SD 8)} and general health (GH) {87 (SD 14) vs. 98 (SD 6)} scores were significantly lower in children with disability (n=37) at 6‐7 years, compared to those (n=74) without disability. FS‐II I scores were significantly associated with disability (OR 0.92; 95% CI 0.87‐0.97; p =0.003). On path analysis, severe HIE, greater IOF and public insurance were associated with poorer 18‐month FS‐II I scores, which, in turn, were associated with disability at 6 to 7 years. Interpretation Poor independent functioning by parental report at 18 months in children with HIE was associated with childhood disability.