Early studies following perinatal hypoxic-ischemic encephalopathy (HIE) suggested expressive language deficits and academic difficulties, but there is only limited detailed study of language development in this population since the widespread adoption of therapeutic hypothermia (TH). Expressive and receptive language testing was performed as part of a larger battery with 45 children with a mean age of 26 months following perinatal HIE treated with TH. Overall cohort outcomes as well as the effects of gender, estimated household income, initial pH and base excess, and pattern of injury on neonatal brain MRI were assessed. The cohort overall demonstrated expressive language subscore, visual-reception subscore, and early learning composite scores significantly below test norms, with relative sparing of receptive language subscores. Poorer expressive language manifested as decreased vocabulary size and shorter utterances. Expressive language subscores showed a significant gender effect, and estimated socioeconomic status showed a significant effect on both receptive and expressive language subscores. Initial blood gas markers and modified Sarnat scoring did not show a significant effect on language subscores. Binarized MRI abnormality predicted a significant effect on both receptive and expressive language subscores; the presence of specific cortical/subcortical abnormalities predicted receptive language deficits. Overall, the language development profile of children following HIE in the era of hypothermia shows a relative strength in receptive language. Gender and socioeconomic status predominantly predict expressive language deficits; abnormalities detectable on MRI predominantly predict receptive language deficits.

中文翻译：

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低温治疗时代围产期缺氧缺血性脑病的学前语言结果。


围产期缺氧缺血性脑病（HIE）后的早期研究表明存在表达性语言缺陷和学业困难，但自从广泛采用低温治疗（TH）以来，对该人群语言发展的详细研究非常有限。表达性和接受性语言测试是对 45 名平均年龄为 26 个月、接受 TH 治疗的围产期 HIE 的儿童进行的大规模测试的一部分。评估了总体队列结果以及性别、估计家庭收入、初始 pH 值和碱过剩以及新生儿脑 MRI 损伤模式的影响。该队列总体上表现出表达性语言分项得分、视觉接收分项得分和早期学习综合得分显着低于测试标准，而接受性语言分项得分相对较低。语言表达能力较差表现为词汇量减少和话语较短。表达性语言分项得分显示出显着的性别影响，估计的社会经济地位对接受性语言分项得分和表达性语言分项得分均显示出显着影响。初始血气标记和修改后的 Sarnat 评分并未显示出对语言分项的显着影响。二值化 MRI 异常预测对接受性和表达性语言子分数有显着影响；特定皮质/皮质下异常的存在预示着接受性语言缺陷。总体而言，低温时代 HIE 儿童的语言发展概况显示出接受性语言的相对优势。性别和社会经济地位主要预测语言表达能力的缺陷； MRI 可检测到的异常主要预测接受性语言缺陷。