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Updated: May 21, 2025
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Multi-organ dysfunction across the neonatal encephalopathy spectrum
Lynn Bitar1, Rachel L Leon1, Yu-Lun Liu2
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Background:
Neonatal hypoxic-ischemic encephalopathy (HIE), the leading cause of neonatal encephalopathy (NE), primarily affects the central nervous system and is associated with multi-organ dysfunction (MOD) and long-term complications. Research often focuses on moderate to severe NE, with limited data on mild cases.
Objective:
To investigate the incidence and severity of MOD in neonates with mild NE and explore its association with HIE severity.
Methods:
Term neonates with NE related to HIE diagnosis between 2009 and 2023 were included. Sarnat staging was used to classify cases into mild and moderate/severe. MOD was assessed on days 1 and 3 post-birth through echocardiography, troponin levels, creatinine levels, urine output, and liver function tests.
Results:
Among 452 neonates with HIE (185 mild, 267 moderate/severe), 57% had liver injury, 55% cardiac injury, and 44% kidney injury in the first day of life. Neonates with mild NE had a MOD rate of 23%, lower than the 37% observed in moderate/severe (p = 0.002). When compared to mild, infants with moderate/severe NE had significantly higher incidences of cardiac (69% vs. 31%; p < 0.001), renal (49% vs. 38%; p = 0.067), and hepatic abnormalities (65% vs. 45%; p = 0.005).
Conclusions:
This study highlights the risk of extra-cranial organ injury even in infants with mild NE, stressing the importance of monitoring all regardless of severity.
Impact:
Comprehensive study prospectively evaluating end-organ dysfunction in a cohort of neonates diagnosed with mild, moderate, and severe NE.
