Related Experiment Video
Updated: Dec 3, 2025
Author Spotlight: Assessing the Feasibility of Using Amplitude-Integrated EEG During Neonatal Transport
Published on: June 21, 2024
Towards a biopsychosocial understanding of neurodevelopmental outcomes in children with hypoxic-ischemic
Ashley Danguecan1,2, Amr I El Shahed2,3, Emily Somerset4
1Department of Psychology, Centre for Brain and Mental Health, Hospital for Sick Children, Toronto, ON, Canada.
Insights
Parental mental health and social risks significantly impact neurodevelopmental outcomes in children with hypoxic-ischemic encephalopathy (HIE), even with therapeutic hypothermia. Understanding these factors is crucial for better prediction and support.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Neonatal Medicine
Background:
- Children with hypoxic-ischemic encephalopathy (HIE) face high risks of neurodevelopmental delay, necessitating a comprehensive approach beyond therapeutic hypothermia.
- Predicting neurodevelopmental outcomes in HIE requires considering both biological and psychosocial factors.
- Existing research often focuses on biological markers, potentially overlooking crucial environmental and familial influences.
Purpose of the Study:
- To investigate the associations between child neurodevelopmental outcomes and factors including brain imaging, parent mental health, prior interventions, and social risk in children with HIE.
- To identify qualitative themes within the parent experience related to their child's condition and outcomes.
- To provide a more holistic understanding of factors influencing HIE recovery and development.
Main Methods:
- Parents of 54 children (6 months–6.5 years) with HIE completed questionnaires on sociodemographics, parent mental health, and child functioning.
- Child neurodevelopmental assessment scores at 18 and 36 months were retrospectively collected from medical records.
- Qualitative analysis of parent-reported experiences was conducted on free-text responses.
Main Results:
- Poorer parental mental health was significantly associated with adverse child psychosocial and language outcomes.
- Social risk emerged as a significant predictor for cognitive and language functioning at both 18 and 36 months.
- Qualitative data revealed parental themes of both hopefulness and persistent concern regarding their child's development.
Conclusions:
- Parental mental health and social context are critical determinants of neurodevelopmental trajectories in children with HIE.
- These psychosocial factors play a substantial role alongside biological considerations in predicting outcomes.
- Integrating assessments of social risk and parental well-being can enhance clinical prediction and intervention strategies for HIE.
Objective:
Children with hypoxic-ischemic encephalopathy (HIE) are at high risk of neurodevelopmental delay despite the widespread adoption of therapeutic hypothermia. Thus, consideration of both biological and psychosocial factors is warranted to better predict outcomes. We examined the associations between various child neurodevelopmental outcomes and potentially influential factors such as brain imaging, parent mental health, previous intervention, and social risk. Qualitative themes in the parent experience were also identified from free-text questionnaire responses. Methods: Parents of 54 children with HIE (ages 6 months-6.5 years) completed questionnaires capturing sociodemographic factors, qualitative perceptions of clinical outcome, parent mental health, and ratings of child adaptive and psychosocial functioning. Neurodevelopmental assessment scores at 18 and 36 months were extracted retrospectively from the medical chart for a subset of children. Results: Linear regression analyses showed significant associations between poorer parent mental health and child psychosocial and language outcomes. In multivariable analyses, social risk served as a significant predictor of 18 and 36 month cognitive and language functioning. Qualitative analyses of parents' written reflections revealed themes of hopefulness and ongoing concern. Conclusion: In children with HIE, social context and parent mental health are strong contributing factors in the pathway of neurodevelopmental outcomes.
