International Journal of General Medicine (Feb 2023)

Clinical Characteristics and Risk Factors of Neonatal Hypoxic-Ischaemic Encephalopathy and Its Associated Neurodevelopmental Outcomes During the First Two Years of Life: A Retrospective Study in Saudi Arabia

  • AlMuqbil M,
  • Alanazi J,
  • Alsaif N,
  • Baarmah D,
  • Altwaijri W,
  • Alrumayyan A,
  • Alrifai MT,
  • Othman F,
  • Al-shehri H,
  • Alsaif S

Journal volume & issue
Vol. Volume 16
pp. 525 – 536

Abstract

Read online

Mohammed AlMuqbil,1– 3 Jawaher Alanazi,2 Nada Alsaif,1 Duaa Baarmah,2 Waleed Altwaijri,1,2 Ahmad Alrumayyan,1,2 Muhammad Talal Alrifai,1,2 Fatmah Othman,3,4 Hassan Al-shehri,5 Saif Alsaif1,3 1College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; 2Division of Pediatric Neurology, King Abdullah Specialist Children’s Hospital (KASCH), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard, Riyadh, Saudi Arabia; 4Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health-Science, Riyadh, Saudi Arabia; 5Department of Pediatrics, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi ArabiaCorrespondence: Mohammed AlMuqbil, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 11481, Saudi Arabia, Tel +966 50533 7752, Email [email protected]: This study aimed to determine the clinical characteristics and factors associated with neonatal hypoxic-ischaemic encephalopathy (HIE) and its neurodevelopmental outcomes.Methods: We conducted retrospective case-control research to investigate the clinical and labour-related risk factors for HIE. In addition, a single-centre cohort study was conducted on infants with HIE to describe their neurodevelopment from birth to 24 months. For this investigation, cases with a diagnosis of HIE who were born at King Abdullah Children’s Specialist Hospital (KASCH), Riyadh, Saudi Arabia, between 2015 and 2019 were identified and matched with controls from the same facility (1:4). Each case’s clinical information was extracted using electronic medical records. In addition, 24-month follow-up HIE cases were included in a cohort study to describe their neurodevelopmental outcomes.Results: The sample includes 60 infants diagnosed with HIE and 234 infants serving as controls, with a mean gestational age of 38.8 weeks (SD 1.6) and a predominance of males (56.4%). Around one-third of the HIE cases (36.6%) had moderate HIE (stage 2), whereas 35.1% of infants had severe HIE (stage 3), according to Sarnat staging. Compared to the control group, children with HIE were twice as likely to be born to mothers with maternal comorbidities and more likely to have prepartum and intrapartum complications. A 24-month follow-up of neurodevelopmental outcomes for HIE babies revealed that approximately 24% exhibited delays in gross motor skill development, 22% in fine motor skill development, 33% in language skill development, and 22% in social skill development.Conclusion: In the HIE group, maternal comorbidities and prepartum or intrapartum complications were more common. The severity grade of HIE can be used to predict neurodevelopmental consequences. Enhancing patient care and rehabilitation requires a minimum of 24 months of neurodevelopmental follow-up.Keywords: hypoxic-ischaemic encephalopathy, seizure, perinatal asphyxia

Keywords