Long-term neurodevelopmental outcome of asphyxiated newborns

Perinatal asphyxia associated with hypoxic-ischemic brain injury remains an important cause of long-term morbidity in both premature and term infants. Early, severe neurologic dysfunction appears to be the most useful indicator that a significant hypoxic-ischemic insult has occurred, and is the best predictor of neurologic sequelae. There are distinct gestational age dependent differences in the vulnerability of specific cerebral structures to hypoxic-ischemic damage, which ultimately determines the type and severity of neurologic sequelae. Both major and minor handicapping conditions are seen, the latter having important consequences on later academic achievement. Long-term, longitudinal follow-up is required for any asphyxiated infant with early intervention as the goal. As newer imaging modalities are employed and studied, we are learning more about the neuropathology of asphyxia and correlating it to outcome. However, the ability to accurately predict long-term neurodevelopmental outcome in seriously asphyxiated infants remains elusive.