Abnormal brain MRI findings in infants with mild neonatal encephalopathy

Researchers from a recent study have found out that 18% of infants with mild encephalopathy had an abnormal short-term outcome, such as abnormal brain magnetic resonance imaging findings.

The study is published in the BMC Pediatrics Journal.

Neonatal encephalopathy due to acute perinatal asphyxia is a major cause of perinatal brain damage. Moderate to severe neonatal encephalopathy is associated with high mortality and morbidity rates. However, the neurodevelopmental outcomes in neonates with mild neonatal encephalopathy are unclear.

Hence, Yoshinori Aoki and colleagues from the Department of Neonatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan carried out this single-center observational study was to assess the short-term outcomes in term neonates with mild neonatal encephalopathy due to perinatal asphyxia.

A secondary aim of the study was to identify predictors of poor prognosis by identifying the characteristics of these infants according to their short-term outcomes.

The investigators retrospectively accessed all infants with perinatal asphyxia at Tokyo Metropolitan Children's Medical Center. In total, 110 term infants with perinatal asphyxia during the study period were screened and 61 were diagnosed with mild neonatal encephalopathy.

An abnormal short-term outcome was defined as any one of the following: seizures or abnormal electroencephalography, abnormal brain magnetic resonance imaging obtained within the first 4 weeks of life, and abnormal neurological examination findings at discharge.

The following results were observed-

a. Eleven (18 %) of these infants had an abnormal short-term outcome.

b. The median Thompson score at admission was significantly higher in infants with abnormal short-term outcomes than in those with normal short-term outcomes (5 [interquartile range, 4-5.5] vs. 2 [interquartile range, 1–3], p < 0.01).

c. Receiver operating characteristic curve analysis showed that a cutoff value of 4 had high sensitivity and specificity (90.9 and 83.0 %, respectively) for the prediction of an abnormal short-term outcome.

Therefore, the authors concluded that "18 % of infants with mild encephalopathy had an abnormal short-term outcome, such as abnormal brain magnetic resonance imaging findings. The Thompson score at admission may be a useful predictor of an abnormal short-term outcome in infants with mild neonatal encephalopathy."