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Minerva Pediatrica 2017 Feb 17

DOI: 10.23736/S0026-4946.17.04791-0


lingua: Inglese

Clinical characteristics predicting abnormal brain magnetic resonance image findings in hypoxic-ischemic encephalopathy infants

Sook K. YUM, Cheong-Jun MOON, Young-Ah YOUN, In K. SUNG

Division of Neonatology, Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea


BACKGROUND: The aim of this study was to elucidate the specific clinical characteristics associated with abnormal brain magnetic resonance image(MRI) findings in hypoxic ischemic encephalopathy(HIE) infants in order to discern how to predict poorer outcomes more accurately.
METHODS: A retrospective data analysis of HIE infants admitted to the neonatal intensive care unit of a tertiary hospital was performed. Baseline perinatal information and physical and neurological findings were compared in HIE infants according to the presence of abnormal brain MRI findings.
RESULTS: A total of 69 infants were enrolled in the study. Of these, 48(69.6%) infants received therapeutic hypothermia, and 60(87.0%) infants presented abnormal findings on brain MRI. Decreased muscle tone and lower Apgar scores were more often observed in infants with abnormal MRI results(p<0.05). The presence of hypotonia and 1- and 5-minute Apgar scores equal to or less than the yielded cut-off values(5.5 and 7.5, respectively)were associated with a 7.23-, 9.14-, 9.78-fold increased risk of having abnormal brain MRI results.
CONCLUSIONS: As muscle tone and Apgar scores were associated with abnormal brain MRI findings in HIE infants, these clinical characteristics may serve as early indicators of poor neurodevelopmental outcomes and signal the need for special attention and in-depth follow-up by MRI.

KEY WORDS: Apgar score - Hypotonia - Hypoxic-ischemic encephalopathy - Magnetic resonance imaging

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