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Published on: June 11, 2020
Mood disorders in children following neonatal hypoxic-ischemic encephalopathy
María Álvarez-García1, Isabel Cuellar-Flores2, Purificación Sierra-García3
1International PhD School, PhD Program in Health Psychology, UNED, Madrid, Spain.
Insights
Children surviving newborn hypoxic-ischemic encephalopathy (NHIE) show an increased risk for mood disturbances. This risk, similar to adults with brain injury, warrants further investigation into NHIE
Area of Science:
- Neonatal neurology
- Child psychiatry
- Developmental pediatrics
Background:
- Newborn hypoxic-ischemic encephalopathy (NHIE) is a serious condition with long-term consequences.
- Mood disorders (MD) are common after adult ischemic brain injury, but less studied in NHIE survivors.
- Understanding NHIE's impact on child mental health is crucial for early intervention.
Purpose of the Study:
- To investigate the prevalence of mood disorders in children who survived NHIE.
- To compare the socio-emotional development of NHIE survivors with healthy children.
- To explore potential correlations between NHIE, developmental status, and mood disturbances.
Main Methods:
- A cohort of 14 children treated for NHIE (without cerebral palsy) and 15 healthy controls (ages 3-6) were assessed.
- Developmental status was evaluated using the Ages and Stages Questionnaire 3 (ASQ-3).
- Socio-emotional status was measured with the Preschool Symptom Self-Report (PRESS) and Child Behavior Checklist (CBCL 1.5-5). Maternal depression (MADRS) and socio-economic factors were also assessed.
Main Results:
- NHIE survivors showed no developmental delay but scored lower on ASQ-3 items compared to controls.
- NHIE children exhibited higher PRESS scores and elevated anxious/depressive symptoms and aggressive behaviors on the CBCL.
- A significant proportion of NHIE children exceeded the clinical cutoff for anxious/depressive symptoms (P = 0.04 vs. controls).
Conclusions:
- Children surviving NHIE demonstrate an increased risk for mood disturbances, mirroring findings in adults with ischemic brain injury.
- These findings highlight the potential for long-term mental health challenges following NHIE.
- Further research is essential to understand and address the mood disorder risk in NHIE survivors.
Background:
Few studies on the consequences following newborn hypoxic-ischemic encephalopathy (NHIE) assess the risk of mood disorders (MD), although these are prevalent after ischemic brain injury in adults.
Objective:
To study the presence of MD in children survivors of NHIE.
Methods:
14 children survivors of NHIE treated with hypothermia and without cerebral palsy and 15 healthy children without perinatal complications were studied aged three to six years for developmental status (Ages and Stages Questionnaire 3 [ASQ-3]) and for socio-emotional status (Preschool Symptom Self-Report [PRESS] and Child Behavior Checklist [CBCL] 1.5-5 tests). Maternal depression was assessed using Montgomery-Asberg Depression Rating Scale (MADRS). Socio-economic factors such as parental educational level or monthly income were also studied.
Results:
NHIE children did not present delay but scored worse than healthy children for all ASQ3 items. NHIE children showed higher scores than healthy children for PRESS as well as for anxious/depressive symptoms and aggressive behavior items of CBCL. In addition, in three NHIE children the CBCL anxious/depressive symptoms item score exceeded the cutoff value for frank pathology (P = 0.04 vs healthy children). There were no differences in the other CBCL items as well as in maternal MADRS or parental educational level or monthly income. Neither ASQ3 scores nor MADRS score or socio-economic factors correlated with PRESS or CBCL scores.
Conclusions:
In this exploratory study children survivors of NHIE showed increased risk of developing mood disturbances, in accordance with that reported for adults after brain ischemic insults. Considering the potential consequences, such a possibility warrants further research.
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