摘要
Objectives: To determine whether the pattern of brain injury in term neonatal encephalopathy is associated with distinct prenatal and perinatal factors and to determine whether the pattern of injury is associated with 30- month neurodev elopmental outcome. Study design: A total of 173 term newborns with neonatal enc ephalopathy from 2 centers underwent magnetic resonance imaging (MRI) at a media n of 6 days of age (range, 1- 24 days). Patterns of injury on MRI were defined on the basis of the predominant site of injury: watershed predominant, basal gan glia/thalamus predominant, and normal. Results: The watershed pattern of injury was seen in 78 newborns (45% ), the basal ganglia/thalamus pattern was seen in 44 newborns (25% ), and normal MRI studies were seen in 51 newborns (30% ). An tenatal conditions such as maternal substance use, gestational diabetes, prematu re rupture of membranes, pre- eclampsia, and intra- uterine growth restriction did not differ across patterns. The basal ganglia/thalamus pattern was associat ed with more severe neonatal signs, including more intensive resuscitation at bi rth (P = .001), more severe encephalopathy (P = .0001), and more severe seizures (P = .0001). The basal ganglia/thalamus pattern was associated with the most im paired motor and cognitive outcome at 30 months. Conclusion: The patterns of bra in injury in term neonatal encephalopathy are associated with different clinical presentations and neurodevelopmental outcomes. Measured prenatal risk factors d id not predict the pattern of brain injury.
Objectives: To determine whether the pattern of brain injury in term neonatal encephalopathy is associated with distinct prenatal and perinatal factors and to determine whether the pattern of injury is associated with 30- month neurodev elopmental outcome. Study design: A total of 173 term newborns with neonatal enc ephalopathy from 2 centers underwent magnetic resonance imaging (MRI) at a media n of 6 days of age (range, 1- 24 days). Patterns of injury on MRI were defined on the basis of the predominant site of injury: watershed predominant, basal gan glia/thalamus predominant, and normal. Results: The watershed pattern of injury was seen in 78 newborns (45% ), the basal ganglia/thalamus pattern was seen in 44 newborns (25% ), and normal MRI studies were seen in 51 newborns (30% ). An tenatal conditions such as maternal substance use, gestational diabetes, prematu re rupture of membranes, pre- eclampsia, and intra- uterine growth restriction did not differ across patterns. The basal ganglia/thalamus pattern was associat ed with more severe neonatal signs, including more intensive resuscitation at bi rth (P = .001), more severe encephalopathy (P = .0001), and more severe seizures (P = .0001). The basal ganglia/thalamus pattern was associated with the most im paired motor and cognitive outcome at 30 months. Conclusion: The patterns of bra in injury in term neonatal encephalopathy are associated with different clinical presentations and neurodevelopmental outcomes. Measured prenatal risk factors d id not predict the pattern of brain injury.
