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Is there a role for therapeutic hypothermia administration in term infants with mild neonatal encephalopathy?

Journal of Perinatology volume 40, pages 522–529 (2020)Cite this article

Subjects

Abstract

Objective

Identifying term infants presenting with early mild neonatal encephalopathy (NE) as candidates for therapeutic hypothermia (TH) remains unclear. Study objectives were to characterize the neonatal clinical, magnetic resonance imaging (MRI), and longer-term outcome in infants with mild NE treated with TH.

Study design

Retrospective cohort study of infants admitted with mild or moderate NE treated with TH. Enrollment criteria included a sentinel event, severe acidosis, DR interventions, and low Apgar scores.

Results

Infants with mild (n = 11) and moderate NE (n = 37) received TH. Mild NE findings included hyperalertness (64%), hypotonia (73%), high level sensory response (91%); 64% progressed to moderate NE. Infants with mild vs. moderate NE had less severe MRI changes (0 vs. 16%) and no cerebral palsy (CP) (0 vs. 13%).

Conclusions

Outcomes were favorable with mild NE whereas four infants with moderate NE developed CP. A potential role for TH in this population requires further study.

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Authors and Affiliations

  1. Department of Pediatrics Division of Newborn Medicine, Weill Cornell Medicine, NewYork Presbyterian Komansky Children’s Hospital, 525 East 68th Street, New York, NY, 10065, USA

    Laura Perretta, Rachel Reed, Gail Ross & Jeffrey Perlman

Authors
  1. Laura Perretta
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  2. Rachel Reed
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  3. Gail Ross
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  4. Jeffrey Perlman
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Contributions

LP and RR conceptualized and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. GR carried out the initial analyses, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. JP conceptualized and designed the study, designed the data collection instruments, coordinated and supervised data collection, critically reviewed the paper for important intellectual content, drafted the initial paper, and reviewed and revised the paper. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jeffrey Perlman.

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Perretta, L., Reed, R., Ross, G. et al. Is there a role for therapeutic hypothermia administration in term infants with mild neonatal encephalopathy?. J Perinatol 40, 522–529 (2020). https://doi.org/10.1038/s41372-019-0562-z

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