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Functional status at 18 months of age as a predictor of childhood disability after neonatal hypoxic-ischemic encephalopathy.

CPQCC Publication
TitleFunctional status at 18 months of age as a predictor of childhood disability after neonatal hypoxic-ischemic encephalopathy.
Publication TypeJournal Article
Year of Publication2014
AuthorsNatarajan G, Shankaran S, Pappas A, Bann C, Tyson JE, McDonald S, Das A, Hintz S, Vohr B, Higgins R
Corporate AuthorsExtended Hypothermia Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
JournalDev Med Child Neurol
Volume56
Issue11
Pagination1052-8
Date Published2014 Nov
ISSN1469-8749
KeywordsActivities of Daily Living, Age Factors, Blindness, Child, Deafness, Developmental Disabilities, Epilepsy, Female, Follow-Up Studies, Humans, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Logistic Models, Male, Movement Disorders, Parents, Prospective Studies, Psychomotor Performance, Randomized Controlled Trials as Topic, Risk Factors, Severity of Illness Index, Surveys and Questionnaires
Abstract

AIM: In children with neonatal hypoxic-ischemic encephalopathy (HIE), we examined the association between 18-month functional status by parental report and disability at 6-7 years.

METHOD: Prospective observational study involving participants in the NICHD randomized controlled trial of hypothermia for HIE. Parent questionnaires-Functional Status-II (FS-II), Impact on Family (IOF) and Family Resource Scale (FRS) at 18 months were correlated with 6- to 7-year developmental assessments. Disability at 6-7 years was defined as IQ < 70, gross motor functional classification scale level III-V, bilateral blindness, deafness, or epilepsy.

RESULTS: Rates of severe HIE (32 vs. 15%), public insurance (73% vs. 47%) and IOF scales were higher and mean (SD) FS-II independence (I) {54 (SD 35) vs. 98 (SD 8)} and general health (GH) {87 (SD 14) vs. 98 (SD 6)} scores were significantly lower in children with disability (n=37) at 6-7 years, compared to those (n=74) without disability. FS-II I scores were significantly associated with disability (OR 0.92; 95% CI 0.87-0.97; p=0.003). On path analysis, severe HIE, greater IOF and public insurance were associated with poorer 18-month FS-II I scores, which, in turn, were associated with disability at 6 to 7 years.

INTERPRETATION: Poor independent functioning by parental report at 18 months in children with HIE was associated with childhood disability.

DOI10.1111/dmcn.12512
Alternate JournalDev Med Child Neurol
PubMed ID24957482
PubMed Central IDPMC4324462
Grant ListU10 HD027856 / HD / NICHD NIH HHS / United States
U10 HD021385 / HD / NICHD NIH HHS / United States
U10 HD021364 / HD / NICHD NIH HHS / United States
U10 HD027880 / HD / NICHD NIH HHS / United States
UG1 HD087229 / HD / NICHD NIH HHS / United States
U10 HD040461 / HD / NICHD NIH HHS / United States
U10 HD027904 / HD / NICHD NIH HHS / United States
UL1 TR000371 / TR / NCATS NIH HHS / United States