A multimodal prognostic evaluation of preterm and term infants with neonatal encephalopathy in a prospective follow-up study

Objective. To evaluate the neurodevelopmental outcomes in preterm and term neonates with neonatal encephalopathy. Method: Concomitant 53 newborns (preterm: 26 and term: 27) with neonatal encephalopathy who were admitted to Ege University Children’s Hospital were included in the study. The infants were prospectively followed up with a high-risk infant program in pediatric neurology outpatient. At 12 months of age, neurodevelopmental outcomes were evaluated with the Guide for Monitoring Child Development (GMCD) and the Ankara Developmental Screening Inventory (ADSI). Four groups were designed for the comparison according to their gestational ages and based on whether they had neonatal seizures or not: Group 1 (preterms with seizures; n=13), Group 2 (preterms without seizures, n=13), Group 3 (term neonates with seizures, n=13) and Group 4 (term neonates without seizures, n = 14). Results: 
The early mortality rate in the NICU was 24.5%. Thirty-two infants were evaluated with AGTE and GMCD tests between 9 and 12 months of age in order to determine their development and early prognosis. An adverse outcome was detected in 28% of preterm infants, and 66.7% of term infants. Among the evaluated possible 10 clinical parameters for the outcome, the magnitude of brain pathology on neuroimaging and the grading of EEG background abnormalities (r-cEEG and aEEG) are significant clinical parameters for adverse outcome in infants with neonatal encephalopathy (Table 1). Conclusion. This study provides the spectrum of neurodevelopmental outcome characteristics and prognostic parameters for adverse outcomes in preterm and term infants with neonatal encephalopathy in an etiologically well-defined cohort.
Keywords: neonatal encephalopathy, overall outcome, neurodevelopmental outcome, neonatal seizures, aEEG