Functional status at 18 months of age as a predictor of childhood disability after neonatal hypoxic-ischemic encephalopathy

Dev Med Child Neurol. 2014 Nov;56(11):1052-8. doi: 10.1111/dmcn.12512. Epub 2014 Jun 24.

Abstract

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.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Blindness / epidemiology
  • Blindness / etiology
  • Child
  • Deafness / epidemiology
  • Deafness / etiology
  • Developmental Disabilities / epidemiology*
  • Developmental Disabilities / etiology*
  • Developmental Disabilities / physiopathology
  • Developmental Disabilities / psychology
  • Epilepsy / epidemiology
  • Epilepsy / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / complications*
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy
  • Infant
  • Logistic Models
  • Male
  • Movement Disorders / epidemiology
  • Movement Disorders / etiology
  • Parents
  • Prospective Studies
  • Psychomotor Performance*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires