Association between cardiovascular care and neurodevelopmental outcomes in infants with neonatal encephalopathy and hemodynamic instability
Association between cardiovascular care and neurodevelopmental outcomes in infants with neonatal encephalopathy and hemodynamic instability

Association between cardiovascular care and neurodevelopmental outcomes in infants with neonatal encephalopathy and hemodynamic instability

J Perinatol. 2025 Feb 17. doi: 10.1038/s41372-025-02230-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the approach to cardiovascular care and long-term outcomes in infants undergoing hypothermia for neonatal encephalopathy (NE).

STUDY DESIGN: This is a retrospective cohort study of 152 infants with NE [SickKids Hospital (Center A, n = 74) or Semmelweis University (Center B, n = 78)], who developed hypotension and underwent neonatal follow-up. Primary outcome was defined as death or neurodevelopmental impairment (<70 on Bayley-II or <85 points on Bayley-III test).

RESULT: The presence of hypoxic injury in the brain MRI increased the odds of adverse outcome by 10.5 fold. In addition, for every 24 h increase in the duration of cardiovascular support the odds of adverse outcome increased by 12%. In a subgroup of patients with detailed echocardiography evaluation lower tricuspid annulus plane systolic excursion was noted in the non-survivors.

CONCLUSION: Hypoxic brain injury and longer cardiovascular therapy are independently associated with the adverse long-term outcome in patients with NE.

PMID:39962327 | DOI:10.1038/s41372-025-02230-3