Neurodevelopmental assessment of infants and toddlers undergoing therapeutic hypothermia in the neonatal period

Hypoxic ischemic encephalopathy is one of the most common health problems seen in term neonates 1-3/1000 and causes morbidity and mortality. Therapeutic hypothermia is accepted as the neuroprotective treatment of hypoxic ischemic encephalopathy. Neurodevelopmental follow-up of neonates with HIE and supporting their development have great importance for later years of life. In this study, neurodevelopmental assessment of infants and young children with HIE who underwent therapeutic hypothermia in the neonatal period was aimed. Twenty two cases (11 females, 11 males) with HIE who had therapeutic hypothermia between the ages of 6 months and 34 months (mean 17.5 months) were included. All cases were evaluated with the Bayley-III Development Scale for Infants and Young Children and Gross Motor Function Scale (GMFM-88) was applied. The Ages and Stages Questionnaire (ASQ-2) was completed by the primary caregivers. At the end of the study, 72.7% (n = 16) of the cases undergoing therapeutic hypothermia were classified as Sarnat Stage 2 and 27.3% (n = 6) as Sarnat Stage 3. According to the Bayley-III result, 68.2% (n=15) of the cases had normal motor development, 18.2% (n=4) had mild to moderate motor delay and 13.6% (n=3) had severe motor delay. In addition, according to ASQ-2 results, it was determined that 40.9% (n=9) of the cases should be followed up in the field of communication, 45.5% (n=10) in the problem solving and 59.1% (n=13) in the personal-social. Infants with HIE who applied therapeutic hypothermia; mode of delivery, severity of hypoxia, history of convulsions and antiepileptic use in NICU, HCO³ֿ value from cord blood gases, duration of stay in NICU and MRI findings affect both the motor development and the prognosis of communication, problem solving and personal-social development. Furthermore, in the neurodevelopmental assessments of children with HIE who received therapeutic hypothermia, "Bayley-III" gross motor subfield and "GMFM 88" all areas, "Bayley-III" fine motor subfield and "ASQ-2" fine motor section and "Bayley-III" gross motor subfield and "ASQ-2" gross motor section can be used interchangeably. Although the motor development of newborns with hypoxic ischemic encephalopathy was parallel to their healthy peers, it was thought that regular follow-up of communication, problem solving and personal social development was important. Key words: hypoxic ischemic encephalopathy, therapeutic hypothermia, neurodevelopmental assessment