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Long-term consequences of neonatal encephalopathy in the hypothermia era: protocol for a follow-up cohort study at 9 years of age. | LitMetric

AI Article Synopsis

  • Therapeutic hypothermia (TH) is now a standard treatment for neonates with moderate to severe neonatal encephalopathy (NE), helping reduce mortality and severe disabilities, but children often face cognitive and behavioral challenges as they grow.
  • A major study will track the developmental outcomes of these children at 9 years old, focusing on comparing their cognitive and emotional skills against peers without NE, while also exploring brain structures and possible influencing factors.
  • The research is ethically approved and funded by the Canadian Institute of Health Research, with plans to publish results and share findings with healthcare providers and parental associations to improve care practices.

Article Abstract

Introduction: Therapeutic hypothermia (TH) became the standard of care treatment for neonates with moderate and severe neonatal encephalopathy (NE) in most industrialized countries about 10 years ago. Although TH is effective in reducing mortality and the incidence of severe developmental disabilities, the recent literature converges in reporting frequent cognitive and behavioural difficulties at school entry in children with NE-TH. Although these challenges are deemed minor compared with cerebral palsy and intellectual disability, their impacts on a child's self-determination and family's well-being are quite significant. Therefore, the nature and extent of these difficulties need to be comprehensively described so that appropriate care can be offered.

Methods And Analysis: The current study will be the largest follow-up study of neonates with NE treated with TH to characterize their developmental outcomes and associated brain structural profiles at 9 years of age. Specifically, we will compare executive function, attention, social cognition, behaviour, anxiety, self-esteem, peer problems, brain volume, cortical features, white matter microstructure and myelination between children with NE-TH and matched peers without NE. Associations of perinatal risk factors and structural brain integrity with cognitive, behavioural and psycho-emotional deficits will be evaluated to inform about the potential aggravating and protective factors associated with function.

Ethics And Dissemination: This study is supported by the Canadian Institute of Health Research (202203PJT-480065-CHI-CFAC-168509), and received approval from the Pediatric Ethical Review Board of the McGill University Health Center (MP-37-2023-9320). The study findings will be disseminated in scientific journals and conferences and presented to parental associations and healthcare providers to inform best practices.

Trial Registration Number: NCT05756296.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10106079PMC
http://dx.doi.org/10.1136/bmjopen-2023-073063DOI Listing

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