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Unavoided cerebral palsy after induced hypothermia
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Orientador(es)
Resumo(s)
Induced hypothermia (IH) reduces the risk of death or cerebral palsy (CP) among term neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). It is now accepted as the standard of care.
The aim of the study is intend to access if the severity of CP among survivors of HIE after IH is similar to their counterparts not submitted to IH or otherwise.
Data from Portuguese Surveillance of Cerebral Palsy registers 5 to 8-year-old children with CP, born in Portugal between 2010-2016 ≥ 36 weeks gestation and andmitted into the neonatal care unit.
From 2967 registered children with CP, 790 were identified as been born in Portugal between 2010 and 2016. From 86 eligible children (42 born 2010-12, 44 born 2013-16), 35 (42%) had been on IH.
Overall, children with CP, if had been on IH had higher prevalence of Dyskinetic CP 57% vs 35%; p 0.04; GMFCS III-V 80% vs 56.5%; p 0.03; MACS II-V 85% vs 62%; p 0.04.
Increased CP complexity: 0 indicators 10% vs 16%; 1-2 indicators 33% vs 51%; 3-4 indicators 57% vs 32%; p 0.057
No differences were found on the prevalences of epilepsy, higher grade affection on Viking SS or cognition and schooling.
Children of the 2013-2016 cohort, compared with the 2010-2012 cohort did not reveal significant improvement in any of the clinical or functionality parameters. Instead, a tendency for a higher prevalence of GMFCS III-V was found (p 0.066).
Children with CP, if having been on IH, seem to be more likely to have high complexity CP.
Surveillance data provide useful information on the effectiveness IH to prevent CP after HIE.
Descrição
Palavras-chave
Cerebral Palsy Induced Hypothermia Severity of Cerebral Palsy Paralisia Cerebral Estados de Saúde e de Doença