Iván Sánchez Fernández1,2, J Leon Morales-Quezada3, Samuel Law4, Paggie Kim5. 1. 1 Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 2. 2 Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain. 3. 3 Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA. 4. 4 Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Canada. 5. 5 Division of Neuroradiology and Pediatric Radiology, Department of Radiology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
Abstract
OBJECTIVE: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. METHODS: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. RESULTS: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemic encephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemic encephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525). CONCLUSION: Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemic encephalopathy and therapeutic hypothermia does not change its prognostic value.
OBJECTIVE: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemicencephalopathy. METHODS: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemicencephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. RESULTS: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemicencephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemicencephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525). CONCLUSION: Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemicencephalopathy and therapeutic hypothermia does not change its prognostic value.
Authors: Jessica L Wisnowski; Pia Wintermark; Sonia L Bonifacio; Christopher D Smyser; A James Barkovich; A David Edwards; Linda S de Vries; Terrie E Inder; Vann Chau Journal: Semin Fetal Neonatal Med Date: 2021-10-29 Impact factor: 3.726