Long-term motor development after hypothermia-treated hypoxic-ischaemic encephalopathy

Mimmi Eriksson Westblad; Kristina Löwing; Katarina Robertsson Grossmann; Mats Blennow; Katarina Lindström

doi:10.1016/j.ejpn.2023.10.003

Long-term motor development after hypothermia-treated hypoxic-ischaemic encephalopathy

Eur J Paediatr Neurol. 2023 Nov:47:110-117. doi: 10.1016/j.ejpn.2023.10.003. Epub 2023 Oct 16.

Authors

Mimmi Eriksson Westblad¹, Kristina Löwing², Katarina Robertsson Grossmann³, Mats Blennow³, Katarina Lindström⁴

Affiliations

¹ Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden. Electronic address: mimmi.eriksson.westblad@ki.se.
² Department of Women's and Children's Health, Division of Paediatric Neurology, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden.
³ Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Department of Neonatology, Stockholm, Sweden.
⁴ Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Department of Child Neurology, Stockholm, Sweden.

PMID: 37862884
DOI: 10.1016/j.ejpn.2023.10.003

Abstract

Aims: To describe longitudinal motor development in children treated with therapeutic- hypothermia (TH) due to neonatal hypoxic-ischaemic encephalopathy (HIE) and to explore motor functioning in early adolescence.

Material and methods: Children treated with TH due to HIE during 2007-2009, in Stockholm, participated in a prospective follow-up study. Motor development was assessed on four occasions, reported as percentiles and at mean ages. Alberta Infant Motor Scale was used at 0.35 years of age, Bayley Scales of Infant and Toddler Development-III at 2.1 years and Movement Assessment Battery for Children (MABC-2) at 7.3 and 11.1 years of age. MABC-2 Checklist was completed by parents at 7.3 and 11.1 years of age. General cognition was assessed using Wechsler Intelligence Scales for Children Fifth Edition (WISC-V).

Results: Thirty-one percent (14/45) of the children had a motor score ≤ 15^th percentile, indicating risk of motor difficulties at 11.1 years of age, and simultaneously the scores from parents of 52% (23/44), indicating risk of motor difficulties in the everyday context. These children had significantly lower motor percentile at 2.1 years of age, but within the normal range. Longitudinal motor development displayed a weak association with WISC-V Full Scale IQ (r_s0.38, p = 0.013).

Conclusion: Among survivors of hypothermia-treated HIE free of moderate/severe cerebral palsy, a third had MABC-2 scores indicating risk of motor difficulties at 11.1 years of age. As motor difficulties became more apparent over time, we suggest that children treated with TH due to neonatal HIE should be followed into at least middle school age.

Keywords: Hypoxic-ischaemic encephalopathy; Motor development; Perinatal asphyxia; Therapeutic hypothermia.

MeSH terms

Cerebral Palsy* / therapy
Child, Preschool
Follow-Up Studies
Humans
Hypothermia*
Hypothermia, Induced*
Hypoxia-Ischemia, Brain* / complications
Hypoxia-Ischemia, Brain* / therapy
Infant
Infant, Newborn
Prospective Studies