Project details


Neurological condition at pre-school age of infants with hypoxic-ischaemic encephalopathy

Neonatal hypoxic-ischaemic encephalopathy neurodevelopmental outcome

Prof. dr. M. Hadders-Algra
B. Vollmer

Nature of the research:
clinical, prospective follow-up study

Fields of study:
pediatrics neurology

Background / introduction
The introduction of hypothermia treatment in infants hypoxic-encephalopathy (HIE) has resulted in a significant increase in the survival of these infants and a decrease of the prevalence of cerebral palsy (CP). Whether neonatal hypothermia treatment is associated with an increase in minor developmental disorders such as, autism spectrum disorder or attention deficit hyperactivity disorder is still unknown. The minor developmental disorders are strongly associated with neurological condition, i.e., with the presence of minor neurological dysfunction (MND).
Research question / problem definition
Is the prevalence of MND at preschool age in survivors of HIE higher than that in the general population? Is the prevalence of MND associated with clinical markers of the severity of HIE?
A large cohort of infants born with HIE (current enrolment n=85) has been prospectively followed by the research group of Clinical and Experimental Sciences in Southampton (UK; Dr. B. Vollmer, neuropaediatrician). The perinatal condition of the infants has been documented in detail; all had MRI and EEG in the newborn period. The children were neurologically assessed at the age of 2 years with the Hempel neurological assessment and this assessment was video recorded. The Hempel assessment has been designed to document the presence of MND. The student’s task is to assist in the assessment of the Hempel videos and to analyze associations between neurological condition and perinatal risk factors, including the severity of HIE, MRI and EEG.
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2. Hadders-Algra M. The neuromotor examination of the preschool child and its prognostic significance. Ment Retard Dev Disabil Res Rev 2005; 11:180-8.
3. Jacobs SE et al. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013 Jan 31;1:CD003311.
4. Schendelaar P, Middelburg KJ, Bos AF, Heineman MJ, Jongbloed-Pereboom M, Hadders-Algra M. The Groningen ART-cohort study: the effects of ovarian hyperstimulation and the IVF laboratory procedures on neurological condition at 2 years. Hum Reprod 2011; 26: 703-12
5. Schreglmann M, Ground A, Vollmer B, Johnson MJ. Systematic review: long-term
cognitive and behavioural outcomes of neonatal hypoxic-ischaemic encephalopathy
in children without cerebral palsy. Acta Paediatr. 2019 Apr 19. doi:
10.1111/apa.14821. [Epub ahead of print]
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