Duration of birth depression and neurodevelopmental outcomes after whole-body hypothermia for hypoxic ischemic encephalopathy in India, Sri Lanka and Bangladesh - an exploratory analysis of the HELIX trial.

Autor:	Burgod C; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Mazlan M; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Pant S; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Krishnan V; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Garegrat R; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Montaldo P; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Muraleedharan P; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom., Bandiya P; Neonatal Unit, Indira Gandhi Institute of Child Health, Bangalore, India., Kamalaratnam CN; Neonatal Unit and Radiology, Madras Medical College, Chennai, India., Chandramohan R; Neonatal Unit and Radiology, Madras Medical College, Chennai, India., Manerkar S; Neonatal Unit and Radiology, Lokmanya Tilak Municipal Medical College, Mumbai, India., Jahan I; Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh., Moni SC; Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh., Shahidullah M; Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh., Rodrigo R; Neonatal Unit, University of Kelaniya, Sri Lanka., Sumanasena S; Neonatal Unit, University of Kelaniya, Sri Lanka., Sujatha R; Neonatal Unit, Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, India., Sathyanathan BP; Neonatal Unit and Radiology, Madras Medical College, Chennai, India., Joshi AR; Neonatal Unit and Radiology, Lokmanya Tilak Municipal Medical College, Mumbai, India., Pressler RR; Department of Neurophysiology, Great Ormond Street Hospital, United Kingdom., Bassett P; Statsconsultancy Ltd, Amersham, United Kingdom., Shankaran S; Department of Neonatal-Perinatal Medicine, Wayne State University, Detroit, MI, USA.; University of Texas at Austin, Dell Children's Hospital, Austin, USA., Thayyil S; Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Southeast Asia [Lancet Reg Health Southeast Asia] 2023 Oct 04; Vol. 20, pp. 100284. Date of Electronic Publication: 2023 Oct 04 (Print Publication: 2024).
DOI:	10.1016/j.lansea.2023.100284
Abstrakt:	Background: Effect of duration of birth depression on neurodevelopmental outcomes in low- and middle-income countries (LMICs) is not known. We examined the association of birth depression with brain injury, neurodevelopmental outcomes, and hypothermia after hypoxic ischemic encephalopathy (HIE) in south Asia. Methods: We compared cerebral magnetic resonance (MR) at 2 weeks, and adverse outcomes (death or moderate or severe disability) at 18 months in 408 babies with moderate or severe HIE who had long birth depression (positive pressure ventilation (PPV) >10 min or Apgar score<6 at 10 min or cord pH < 7.0) and short birth depression (PPV for 5-10 min or Apgar score<6 at 5 min, but ≥6 at 10 min). Findings: Long depression group (n = 201) had more severe HIE (32.8% versus 6.8%), mortality (47.5% versus 26.4%), death or disability at 18 months (62.2% versus 35.4%) (all p < 0.001), MR injury (Odds ratio; 95% CI) to basal ganglia (2.4 (1.3, 4.1); p = 0.003), posterior limb of internal capsule (2.3 (1.3, 4.3); p < 0.001) and white matter (1.7 (1.1, 2.7); p = 0.021), and lower thalamic N-acetylaspartate levels (7.69 ± 1.84 versus 8.29 ± 1.60); p = 0.031) than short depression group (n = 207). Three babies had no heartbeat at 5 min, of which 1 died and 2 survived with severe disability. No significant interaction between the duration of birth depression and whole-body hypothermia was seen for any of the MR biomarker or clinical outcomes. Interpretation: Long birth depression was associated with more brain injury and adverse outcomes than short depression. Effect of hypothermia was not modified by duration of birth depression. Funding: National Institute for Health Research. Competing Interests: None. (© 2023 The Author(s).)
Databáze:	MEDLINE
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