Temporal Trends in the Severity and Mortality of Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Hypothermia

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cristina Vega-Del-Val ◽  
Juan Arnaez ◽  
Sonia Caserío ◽  
Elena Pilar Gutiérrez ◽  
Marta Benito ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Cross Sectional Study ◽  
Annual Incidence ◽  
Hypoxic Ischemic Encephalopathy ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Changes Over Time ◽  
Ischemic Encephalopathy ◽  
Annual Decline ◽  
Over Time

<b><i>Introduction:</i></b> There is a paucity of studies examining temporal trends in the incidence and mortality of moderate-to-severe hypoxic-ischemic encephalopathy (HIE) during the last decade of therapeutic hypothermia (TH). <b><i>Methods:</i></b> Multicenter cross-sectional study of all infants ≥35 weeks gestational age diagnosed with moderate-to-severe HIE within 6 h of birth in an extensive region of Spain between 2011 and 2019, in order to detect trend changes over time in the (1) annual incidence, (2) severity of neurological and systemic organ involvement, and (3) neonatal death from HIE. <b><i>Results:</i></b> Annual incidence rate of moderate-to-severe HIE was 0.84 (95% confidence interval [CI] 0.7–0.97) per 1,000 births, without trend changes over time (<i>p</i> = 0.8), although the proportion of severe HIE infants showed an average annual decline of 0.86 points (95% CI 0.75–0.98). There were 102 (70%) infants diagnosed with moderate HIE and 44 (30%) with severe HIE. TH was offered to 139/146 (95%) infants. Infants with clinical and/or electrical seizures showed a decreasing trend from 56 to 28% (<i>p</i> = 0.006). Mortality showed a nonstatistically significant decline (<i>p</i> = 0.4), and the severity of systemic damage showed no changes (<i>p</i> = 0.3). Obstetric characteristics remained unchanged, while higher perinatal pH values (<i>p</i> = 0.03) and Apgar scores (<i>p</i> = 0.05), and less need for resuscitation (<i>p</i> = 0.07), were found over time. <b><i>Conclusion:</i></b> The annual incidence of moderate-to-severe HIE has stabilized at around 1 per 1,000 births, with a temporal trend toward a decrease in severe HIE infants and a slight decline of mortality. No association was found between temporal trends and changes in perinatal/obstetric characteristics over time.

scholarly journals Electrolyte imbalance in neonates with hypoxic ischemic encephalopathy: A single center study.

2020 ◽  
Vol 27 (10) ◽  
pp. 2159-2164
Author(s):  
Muhammad Shamaoon ◽  
Nadia Razzaq ◽  
Muhammad Ahsan ◽  
Arslan Ahmad ◽  
Tehmina Maqbool ◽  
...  
Keyword(s):  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Hypoxic Ischemic Encephalopathy ◽  
Electrolyte Imbalance ◽  
Control Group ◽  
Serum Electrolyte ◽  
Cross Sectional ◽  
Electrolyte Level ◽  
Ischemic Encephalopathy

Objectives: To determine the mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy. Study Design: Descriptive Cross Sectional study. Setting: Pediatric Ward, Emergency and OPD, Allied Hospital, Faisalabad. Period: December 2017 to May 2018. Material & Methods: In our study, out of 190 cases were included, Results: mean g. age was calculated as 39.44+1.51 weeks, 49.47% (n=94) were male and 50.53% (n=96) were females. Mean APGAR score at 1 minute was calculated as 4.59+0.49 whereas 5.41+0.67 at 5 minutes. Mean weight of the neonates was calculated as 2771.58+256.83 grams. Frequency of delivered through history of fetal distress was recorded in 43.68% (n=83), mean serum electrolytes shows that serum sodium 137.71+1.69 mg/dl, serum potassium 3.92+0.18 mg/dl and serum calcium 8.45+0.51 mg/dl. Conclusion: We concluded that mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy were in normal range, however, in absence of control group and data analysis in qualitative way, we are unable to record the frequency of hypocalcemia, hyponatremia and hyperkalemia, which may be done in coming trials.

scholarly journals Patterns of neurobehavioral functioning in school-aged survivors of neonatal jaundice and hypoxic-ischemic encephalopathy in Kilifi, Kenya: A cross-sectional study

2020 ◽  
Vol 4 ◽  
pp. 95
Author(s):  
Dorcas N. Magai ◽  
Charles R Newton ◽  
Paul Mwangi ◽  
Hans M. Koot ◽  
Amina Abubakar
Keyword(s):  
Motor Function ◽  
Neonatal Jaundice ◽  
Cross Sectional Study ◽  
Hypoxic Ischemic Encephalopathy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gross Motor ◽  
School Aged Children ◽  
Communication Function ◽  
Ischemic Encephalopathy

Background: Studies in high-income countries have reported that school-aged children who survive neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) develop long-term neurocognitive problems. However, less is known about the patterns of functioning in school-aged survivors of NNJ and HIE in sub-Saharan Africa. This study examined patterns of functioning in school-aged children who survived NNJ and HIE in Kilifi, Kenya. Methods: This is a cross-sectional study that included 107 survivors of NNJ/HIE (64 with NNJ, 43 with HIE), aged 6-12 years, admitted to Kilifi County Hospital on the Kenyan Coast. The Gross Motor Function Classification System (GMFCS), Adapted Communication Profile, Raven’s Coloured Progressive Matrices (RCPM) and an epilepsy screening tool were used to assess gross motor function, communication function, intellectual functioning, and epilepsy, respectively. Results: Most of the survivors of NNJ (95.2%) and HIE (95.3%) had no impairments in gross motor functioning. A small percentage of the children in the NNJ and HIE groups had profound problems in their communication (4.7% and 4.7%); expressive communication function (4.7% and 4.7%); social functions (3.1% and 2.3%); receptive communication (4.7% and 2.3%); and communicative effectiveness (4.7% and 2.3%). Cognitive impairment was reported in 10.9% and 11.9% for NNJ and HIE survivors, respectively. Active epilepsy was detected in 1.6% of survivors of NNJ and 2.3% of survivors of HIE. All children had normal hearing and visual functioning except one participant who presented with mild visual acuity problems. Conclusions: Most school-aged children who survive with NNJ and HIE have normal motor and communication function; however, one in ten are likely to present with lowered intellectual functioning compared to the normative sample.

scholarly journals Patterns of neurobehavioral functioning in school-aged survivors of neonatal jaundice and hypoxic-ischemic encephalopathy in Kilifi, Kenya: A cross-sectional study

2019 ◽  
Vol 4 ◽  
pp. 95
Author(s):  
Dorcas N. Magai ◽  
Charles R Newton ◽  
Paul Mwangi ◽  
Hans M. Koot ◽  
Amina Abubakar
Keyword(s):  
Motor Function ◽  
Neonatal Jaundice ◽  
Cross Sectional Study ◽  
Hypoxic Ischemic Encephalopathy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gross Motor ◽  
School Aged Children ◽  
Communication Function ◽  
Ischemic Encephalopathy

Background: Studies in high-income countries have reported that school-aged children who survive neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) develop long-term neurocognitive problems. However, less is known about the patterns of functioning in school-aged survivors of NNJ and HIE in sub-Saharan Africa. This study examined patterns of functioning in school-aged children who survived NNJ and HIE in Kilifi, Kenya. Methods: This is a cross-sectional study that included 107 survivors of NNJ/HIE (64 with NNJ, 43 with HIE), aged 6-12 years, admitted to Kilifi County Hospital on the Kenyan Coast. The Gross Motor Function Classification System (GMFCS), Adapted Communication Profile, Raven’s Coloured Progressive Matrices (RCPM) and an epilepsy screening tool were used to assess gross motor function, communication function, intellectual functioning, and epilepsy, respectively. Results: Most of the survivors of NNJ (95.2%) and HIE (95.3%) had no impairments in gross motor functioning. A small percentage of the children in the NNJ and HIE groups had profound problems in their communication (4.7% and 4.7%); expressive communication function (4.7% and 4.7%); social functions (3.1% and 2.3%); receptive communication (4.7% and 2.3%); and communicative effectiveness (4.7% and 2.3%). Cognitive impairment was reported in 10.9% and 11.9% for NNJ and HIE survivors, respectively. Active epilepsy was detected in 1.6% of survivors of NNJ and 2.3% of survivors of HIE. All children had normal hearing and visual functioning except one participant who presented with mild visual acuity problems. Conclusions: Most school-aged children who survive with NNJ and HIE have normal motor and communication function; however, one in ten are likely to present with lowered intellectual functioning compared to the normative sample.

scholarly journals Electroencephalogram abnormalities in full term infants with history of severe asphyxia

2016 ◽  
Vol 55 (6) ◽  
pp. 297
Author(s):  
Susanti Halim ◽  
I Gusti Nyoman Made Suwarba ◽  
I Made Kardana
Keyword(s):  
Cross Sectional Study ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Chi Square ◽  
Term Infants ◽  
Cross Sectional ◽  
Term Neonates ◽  
History Of ◽  
Abnormal Eegs ◽  
Ischemic Encephalopathy

ingtool used to determine developmental and electrical problemsin the brain. A history of severe asphyxia is a risk factor for thesebrain problems in infants.Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severeasphyxia, hypoxic ischemic encephalopathy (HIE), and spontaneousdelivery.Methods This cross-sectional study was conducted at thePediatric Outpatient Department of Sanglah Hospital, Denpasar,from November 2013 to January 2014. Subjects were fullterminfants aged 1 month who were delivered and/or hospitalized atSanglah Hospital. All subjects underwent EEG. The EEGs wereinterpreted by a pediatric neurology consultant, twice, with aweek interval between readings. Clinical data were obtainedfrom medical records. Association between abnormal ECG andsevere asphyxia were analyzed by Chi-square and multivariablelogistic analyses.Results Of 55 subjects, 27 had a history of severe asphyxia and 28were vigorous babies. Forty percent (22/55) of subjects had abnormalEEG findings, 19/22 of these subjects having history of severeasphyxia, 15/22 had history of hypoxic-ischemic encephalopathy(HIE), and 20/22 were delievered vaginally. There were strongcorrelations between the prevalence of abnormal EEG and historyof severe asphyxia, HIE, and spontaneous delivery.Conclusion Prevalence of abnormal EEG among full-term neonatesreferred to neurology/growth development clinic is around40%, with most of them having a history of severe asphyxia. AbnormalEEG is significantly associated to severe asphyxia, HIE, andspontaneous delivery.

scholarly journals Preliminary evidence for progressive prefrontal abnormalities in adolescents and young adults with bipolar disorder

2009 ◽  
Vol 15 (3) ◽  
pp. 476-481 ◽  
Author(s):  
JESSICA H. KALMAR ◽  
FEI WANG ◽  
LINDA SPENCER ◽  
ERIN EDMISTON ◽  
CHERYL M. LACADIE ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Young Adults ◽  
Longitudinal Design ◽  
Preliminary Evidence ◽  
Cross Sectional Study ◽  
Anterior Cingulate ◽  
Volume Changes ◽  
Cross Sectional ◽  
Changes Over Time ◽  
Over Time

AbstractPrevious cross-sectional study of ventral prefrontal cortex (VPFC) implicated progressive volume abnormalities during adolescence in bipolar disorder (BD). In the present study, a within-subject, longitudinal design was implemented to examine brain volume changes during adolescence/young adulthood. We hypothesized that VPFC volume decreases over time would be greater in adolescents/young adults with BD than in healthy comparison adolescents/young adults. Eighteen adolescents/young adults (10 with BD I and 8 healthy comparison participants) underwent two high-resolution magnetic resonance imaging scans over approximately 2 years. Regional volume changes over time were measured. Adolescents/young adults with BD displayed significantly greater volume loss over time, compared to healthy comparison participants, in a region encompassing VPFC and rostral PFC and extending to rostral anterior cingulate cortex (p < .05). Additional areas where volume change differed between groups were observed. While data should be interpreted cautiously due to modest sample size, this study provides preliminary evidence to support the presence of accelerated loss in VPFC and rostral PFC volume in adolescents/young adults with BD. (JINS, 2009, 15, 476–481.)

scholarly journals Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008–2016: a repeated cross-sectional study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Minoru Takakura ◽  
Masaya Miyagi ◽  
Akira Kyan
Keyword(s):  
Time Trends ◽  
Parental Education ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
School Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Adolescents ◽  
Index Of Inequality ◽  
Over Time

Abstract Background Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016. Methods We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated. Results Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time. Conclusions Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.

scholarly journals Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

2021 ◽  
Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa
Keyword(s):  
Developing Countries ◽  
Head Injury ◽  
Road Traffic ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Incidence And Mortality ◽  
Male Female Ratio ◽  
Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

scholarly journals Trend and status of out-of-pocket payments for healthcare in Iran: equity and catastrophic effect

2020 ◽  
Vol 95 (1) ◽  
Author(s):  
Satar Rezaei ◽  
Abraha Woldemichael ◽  
Mohammad Ebrahimi ◽  
Sina Ahmadi
Keyword(s):  
Household Income ◽  
Cross Sectional Study ◽  
Publicly Funded ◽  
Socioeconomically Disadvantaged ◽  
Time Series Regression ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Main Determinants ◽  
Over Time ◽  
Yearly Data

Abstract Background Equity in the distribution of health care resources and mitigating the risk of out-of-pocket (OOP) catastrophic healthcare expenditures (CHE) are the major objectives of the health system of a country. This study aims to measure equity in OOP payments for healthcare and the incidence of CHE among Iranian households over time. Methods This retrospective cross-sectional study utilized data extracted from the household income and expenditure survey (HIES) of Iran, collected by the Statistical Center of Iran. The analysis included a total of 174,341 households’ five yearly data of 6 years starting from 1991 to 2017. Kakwani progressivity index (KPI) was used to measure the equity in OOP payment for each year and examine the households’ incidence of CHE at 20%, 30%, and 40% of their capacities to pay (CTP). The trend series regression analysis was used to examine the trend in the KPI and the incidence of the CHE over time. Results The findings indicated that the households’ expenditure on health out of their monthly budgets for the years 1991 and 2017 were 2.1% and 10.1%, respectively. The KPI for the OOP payment was negative for all 6-year observations (1991 = − 0.680; 1996 = − 0.608; 2001 = − 0.554; 2006 = − 0.265; 2011 = − 0.225, and 2017 = − 0.207), indicating that the OOP payments for healthcare are regressive and more concentrated among the socioeconomically disadvantaged households. There was a statistically significant (p = 0.003) increase in the KPI (i.e., decline in the regressivity) over time. The incidence of the CHE (1.12, 1.93, and 3.71%) in 1991 at the CTP levels of 20%, 30%, and 40% was lower than the incidence at the corresponding levels of CTP (5.26, 10.88, and 22.16) in 2017. The findings of the time-series regression indicated a statistically significant (p < 0.05) increase in the incidence of the CHE at the 20%, 30%, and 40% levels of the households’ CTP. Conclusions The current study demonstrated that OOP payment as a source of healthcare funding in Iran is inequitable. While the use of interventions such as the prepaid and publicly funded programs may contribute to the reduction of CHE and improvement of equity in healthcare financing, further inequality analyses in the incidence of the CHE among households and its main determinants can contribute to evidence-informed planning to reduce the CHE in the context.

Sign in / Sign up

Export Citation Format

Share Document