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Related Experiment Video

Updated: May 21, 2025

Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy

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.

Pediatric Research

|March 20, 2025

Summary

Even mild neonatal encephalopathy (NE) carries a risk of multi-organ dysfunction (MOD). This study shows that monitoring for organ injury is crucial for all neonates with NE, regardless of severity.

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Last Updated: May 21, 2025

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Published on: October 28, 2022

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Published on: November 20, 2015

Area of Science:

Neonatalogy
Pediatric Neurology
Critical Care Medicine

Background:

Neonatal hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal encephalopathy (NE), leading to central nervous system issues and multi-organ dysfunction (MOD).
Existing research primarily addresses moderate to severe NE, with limited data on mild NE cases.

Purpose of the Study:

To determine the incidence and severity of MOD in neonates diagnosed with mild NE.
To examine the relationship between MOD and the severity of HIE.

Main Methods:

A cohort of term neonates diagnosed with NE due to HIE between 2009 and 2023 was analyzed.
Cases were stratified into mild and moderate/severe NE using Sarnat staging.
Multi-organ dysfunction was evaluated on days 1 and 3 post-birth using echocardiography, troponin, creatinine, urine output, and liver function tests.

Main Results:

Of 452 neonates with HIE, 57% experienced liver injury, 55% cardiac injury, and 44% kidney injury within the first day.
Neonates with mild NE exhibited a 23% MOD rate, significantly lower than the 37% in moderate/severe NE cases (p=0.002).
Moderate/severe NE cases showed higher incidences of cardiac (69% vs. 31%), renal (49% vs. 38%), and hepatic (65% vs. 45%) abnormalities compared to mild NE.

Conclusions:

This study underscores that extra-cranial organ injury can occur even in neonates with mild NE.
It emphasizes the necessity of vigilant monitoring for organ dysfunction in all neonates diagnosed with NE, irrespective of clinical severity.