TY - JOUR
T1 - Patterns of brain injury in term neonatal encephalopathy
AU - Miller, Steven P.
AU - Ramaswamy, Vijay
AU - Michelson, David
AU - Barkovich, A. James
AU - Holshouser, Barbara
AU - Wycliffe, Nathaniel
AU - Glidden, David V.
AU - Deming, Douglas
AU - Partridge, J. Colin
AU - Wu, Yvonne W.
AU - Ashwal, Stephen
AU - Ferriero, Donna M.
N1 - Funding Information:
Supported by the National Center for Research Resources (5 M01 RR-01271), US Public Health Service, and by the National Institutes of Health (NS35902). Dr Miller is supported by the Canadian Institutes of Health Research. Mr Ramaswamy was supported by the American Pediatric Society - Society for Pediatric Research summer research program (NIH grant HD007446).
PY - 2005/4
Y1 - 2005/4
N2 - Objectives: To determine whether the pattern of brain injury in term neonatal encephalopathy is associated with distinct prenatal and perinatal factors and to determine whether the pattern of injury is associated with 30-month neurodevelopmental outcome. Study design: A total of 173 term newborns with neonatal encephalopathy from 2 centers underwent magnetic resonance imaging (MRI) at a median of 6 days of age (range, 1-24 days). Patterns of injury on MRI were defined on the basis of the predominant site of injury: watershed predominant, basal ganglia/thalamus predominant, and normal. Results: The watershed pattern of injury was seen in 78 newborns (45%), the basal ganglia/thalamus pattern was seen in 44 newborns (25%), and normal MRI studies were seen in 51 newborns (30%). Antenatal conditions such as maternal substance use, gestational diabetes, premature rupture of membranes, pre-eclampsia, and intra-uterine growth restriction did not differ across patterns. The basal ganglia/thalamus pattern was associated with more severe neonatal signs, including more intensive resuscitation at birth (P = .001), more severe encephalopathy (P = .0001), and more severe seizures (P = .0001). The basal ganglia/thalamus pattern was associated with the most impaired motor and cognitive outcome at 30 months. Conclusion: The patterns of brain injury in term neonatal encephalopathy are associated with different clinical presentations and neurodevelopmental outcomes. Measured prenatal risk factors did not predict the pattern of brain injury.
AB - Objectives: To determine whether the pattern of brain injury in term neonatal encephalopathy is associated with distinct prenatal and perinatal factors and to determine whether the pattern of injury is associated with 30-month neurodevelopmental outcome. Study design: A total of 173 term newborns with neonatal encephalopathy from 2 centers underwent magnetic resonance imaging (MRI) at a median of 6 days of age (range, 1-24 days). Patterns of injury on MRI were defined on the basis of the predominant site of injury: watershed predominant, basal ganglia/thalamus predominant, and normal. Results: The watershed pattern of injury was seen in 78 newborns (45%), the basal ganglia/thalamus pattern was seen in 44 newborns (25%), and normal MRI studies were seen in 51 newborns (30%). Antenatal conditions such as maternal substance use, gestational diabetes, premature rupture of membranes, pre-eclampsia, and intra-uterine growth restriction did not differ across patterns. The basal ganglia/thalamus pattern was associated with more severe neonatal signs, including more intensive resuscitation at birth (P = .001), more severe encephalopathy (P = .0001), and more severe seizures (P = .0001). The basal ganglia/thalamus pattern was associated with the most impaired motor and cognitive outcome at 30 months. Conclusion: The patterns of brain injury in term neonatal encephalopathy are associated with different clinical presentations and neurodevelopmental outcomes. Measured prenatal risk factors did not predict the pattern of brain injury.
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U2 - 10.1016/j.jpeds.2004.12.026
DO - 10.1016/j.jpeds.2004.12.026
M3 - Article
C2 - 15812446
SN - 0022-3476
VL - 146
SP - 453
EP - 460
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -