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Title: | Duration of birth depression and neurodevelopmental outcomes after whole-body hypothermia for hypoxic ischemic encephalopathy in India, Sri Lanka and Bangladesh - an exploratory analysis of the HELIX trial |
Authors: | Burgod, C. Mazlan, M. Pant, S. Krishnan, V. Garegrat, R. Montaldo, P. Muraleedharan, P. Bandiya, P. Kamalaratnam, C.N. Chandramohan, R. Manerkar, S. Jahan, I. Moni, S.C. Shahidullah, M. Rodrigo, R. Sumanasena, S. Sujatha, R. Sathyanathan, B.P. Joshi, A.R. Pressler, R.R. Bassett, P. Shankaran, S. Thayyil, S. |
Keywords: | Hypoxic ischaemic encephalopathy Magnetic resonance Newborn. |
Issue Date: | 2024 |
Publisher: | Elsevier |
Citation: | The Lancet Regional Health - Southeast Asia.2024;20:100284.[Epub 2023 Oct 4] |
Abstract: | BACKGROUND: Effect of duration of birth depression on neurodevelopmental outcomes in low- and middle-income countries (LMICs) is not known. We examined the association of birth depression with brain injury, neurodevelopmental outcomes, and hypothermia after hypoxic ischemic encephalopathy (HIE) in south Asia. METHODS: We compared cerebral magnetic resonance (MR) at 2 weeks, and adverse outcomes (death or moderate or severe disability) at 18 months in 408 babies with moderate or severe HIE who had long birth depression (positive pressure ventilation (PPV) >10 min or Apgar score<6 at 10 min or cord pH < 7.0) and short birth depression (PPV for 5-10 min or Apgar score<6 at 5 min, but ≥6 at 10 min). FINDINGS: Long depression group (n = 201) had more severe HIE (32.8% versus 6.8%), mortality (47.5% versus 26.4%), death or disability at 18 months (62.2% versus 35.4%) (all p < 0.001), MR injury (Odds ratio; 95% CI) to basal ganglia (2.4 (1.3, 4.1); p = 0.003), posterior limb of internal capsule (2.3 (1.3, 4.3); p < 0.001) and white matter (1.7 (1.1, 2.7); p = 0.021), and lower thalamic N-acetylaspartate levels (7.69 ± 1.84 versus 8.29 ± 1.60); p = 0.031) than short depression group (n = 207). Three babies had no heartbeat at 5 min, of which 1 died and 2 survived with severe disability. No significant interaction between the duration of birth depression and whole-body hypothermia was seen for any of the MR biomarker or clinical outcomes. INTERPRETATION: Long birth depression was associated with more brain injury and adverse outcomes than short depression. Effect of hypothermia was not modified by duration of birth depression. FUNDING: National Institute for Health Research. |
Description: | In PUBMED; Scopus ESCI |
URI: | http://repository.kln.ac.lk/handle/123456789/27449 |
ISSN: | 2772-3682 (Electronic) |
Appears in Collections: | Journal/Magazine Articles |
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