Head Growth in Infants With Hypoxic-Ischemic Encephalopathy: Correlation With Neonatal Magnetic Resonance Imaging

The aims of the study were to establish the relationship between head growth in the first year of life with the pattern on injury on neonatal magnetic resonance imaging (MRI) in infants with hypoxic-ischemic encephalopathy (HIE) and to relate these to the neurodevelopmental outcome. Fifty-two term i...

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Bibliographic Details
Published in:	Pediatrics (Evanston) Vol. 106; no. 2; pp. 235 - 243
Main Authors:	Mercuri, Eugenio, Ricci, Daniela, Cowan, Frances M, Lessing, Daniella, Frisone, Maria F, Haataja, Leena, Counsell, Serena J, Dubowitz, Lilly M, Rutherford, Mary A
Format:	Journal Article
Language:	English
Published:	Elk Grove Village, IL Am Acad Pediatrics 01-08-2000 American Academy of Pediatrics
Subjects:	Apgar Score Asphyxia Neonatorum - diagnosis Babies Biological and medical sciences Brain - pathology Brain Damage, Chronic - diagnosis Cephalometry Delivery. Postpartum. Lactation Disorders Encephalitis Encephalopathy Female Fetal Distress - diagnosis Follow-Up Studies Growth Gynecology. Andrology. Obstetrics Head Head - growth & development Humans Hypoxia-Ischemia, Brain - diagnosis Infant Infant, Newborn Infants (Newborn) Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Microcephaly - diagnosis Nervous system Neurologic Examination Neurology Newborn infants NMR Nuclear magnetic resonance Pediatrics Physical growth Physiological aspects Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk Factors Human Measurement Psychomotor development Perimeter Nervous system diseases Neonatal Prognosis Radiodiagnosis Infant Nuclear magnetic resonance imaging Cerebral disorder Ischemia Encephalopathy Cohort study Central nervous system disease Medical imagery Hypoxia Diagnosis Brain (vertebrata)
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Summary:	The aims of the study were to establish the relationship between head growth in the first year of life with the pattern on injury on neonatal magnetic resonance imaging (MRI) in infants with hypoxic-ischemic encephalopathy (HIE) and to relate these to the neurodevelopmental outcome. Fifty-two term infants who presented at birth with a neonatal encephalopathy consistent with HIE and who had neonatal brain MRI were entered into the study. Head circumference charts were evaluated retrospectively and the head growth over the first year of life compared with the pattern of brain lesions on MRI and with the neurodevelopmental outcome at 1 year of age. Suboptimal head growth was classified as a drop of >2 standard deviations across the percentiles with or without the development of microcephaly, which was classified as a head circumference below the third percentile. There was no statistical difference between the neonatal head circumferences of the infants presenting with HIE and control infants. At 12 months, microcephaly was present in 48% of the infants with HIE, compared with 3% of the controls. Suboptimal head growth was documented in 53% of the infants with HIE, compared with 3% of the controls. Suboptimal head growth was significantly associated with the pattern of brain lesions, in particular to involvement of severe white matter and to severe basal ganglia and thalamic lesions. Suboptimal head growth predicted abnormal neurodevelopmental outcome with a sensitivity of 79% and a specificity of 78%, compared with the presence of microcephaly at 1 year of age, which had a sensitivity of only 65% and a specificity of 73%. The exceptions were explained by infants with only moderate white matter abnormalities who had suboptimal head growth but normal outcome at 1 year of age and by infants with moderate basal ganglia and thalamic lesions only who had normal head growth but significant motor abnormality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0031-4005 1098-4275
DOI:	10.1542/peds.106.2.235