Clinical and electrophysiologic predictors of outcome in high-risk newborns: A 5-year prospective study

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  • Seventh Congress of the International Child Neurology Association

    October 2-8, 1994 San Francisco, California

    ABSTRACTS

    1. PREDICTION OF SEVERE ADVERSE OUTCOME AFTER MODERATE OR SEVERE BIRTH ASPHYXIA Maja Steinlin, Paul G. Ekert, Susan Blaser, Hiroshi Otsubo, Margot J. Taylor, Hilary E. Whyte, and Max Perlman, Toron- to, Canada

    We wished to predict severe, adverse outcome in term infants with birth asphyxia as defined in an earlier study [1]. Perinatal data (i.e., perinatal risk factors, neurologic findings, other organ ischemia, therapies and laboratory findings, neuroimaging, and electrophysiology) were collected retrospectively for 1984-1991 (n = 109). We report the results of univariate analyses of the association between the more important findings. Predictors in- cluded: FHR = type II decelerations or sustained bradycardia, SR = spontaneous respiration onset > 10 min, AO = anuria, oliguria >48 hours, EOS = early-onset seizures within 6 hours; SP = persistent seizures over 48 hours; VEP ---- absent visual evoked potentials; EEG = severe abnormalities (i.e., electroce- rebral silence, flat or burst suppression background). The pri- mary outcome was death (n = 11) or severe quadriparesis and severe mental retardation (n = 30). Odds ratio (OR), confidence interval (CI), and P values are listed in Table 1. These variables strongly associated with severe adverse outcomes and will to- gether with other recognized perinatal risk factors for severe brain damage be subjected to multivariate analyses. Reference: [1] Taylor M J, Murphy WJ, Whyte HE. Prognostic reliability of SEPs and VEPs in asphyxiated term infants. Dev Med Child Neurol 1992;34:507-15.

    Table 1-1.

    OR CI P Value

    SR: 3.91 (1.3, 12.15)

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