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School outcomes after HIE: a population-based cohort study

Philippa Rees1, Mithilesh Dronavalli2, Ben Carter3

  • 1Population Policy and Practice, University College London Institute of Child Health, London, UK p.rees@ucl.ac.uk.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|June 8, 2025
PubMed

Insights

Children with moderate-severe hypoxic ischaemic encephalopathy (HIE) show lower academic performance but most meet standards. Mild HIE cases perform similarly to peers, highlighting the need for tailored family support.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Developmental Psychology

Background:

  • Hypoxic ischaemic encephalopathy (HIE) is a serious birth complication affecting newborns.
  • Long-term school performance outcomes for children with HIE require further investigation.
  • Understanding academic trajectories is crucial for early intervention and support.

Purpose of the Study:

  • To compare the school performance of children with HIE against population controls.
  • To analyze academic outcomes from childhood through early adolescence.
  • To identify differences based on HIE severity (mild vs. moderate-severe).

Main Methods:

  • Population-based cohort study in New South Wales, Australia.
  • Inclusion of 550 infants with HIE and 558,355 population controls born between 2008-2013 (≥35 weeks gestation).
  • Assessment of national school performance (reading, writing, numeracy, etc.) at ages 8-9, 10-11, and 12-13 years using linear regression and growth-curve modeling.

Main Results:

  • Children with moderate-severe HIE demonstrated significantly lower academic scores (z-scores) compared to controls across all age groups, particularly in reading and writing.
  • The academic performance gap for moderate-severe HIE cases remained consistent over time.
  • Despite lower passing rates, the majority (62.4%) of moderate-severe HIE cases passed each school year; mild HIE cases showed no significant difference from controls at age 8-9.

Conclusions:

  • Children with moderate-severe HIE exhibit lower academic achievement but generally meet national standards by early adolescence.
  • Mild HIE does not appear to impact school performance compared to peers.
  • Findings underscore the importance of providing tailored support for families of children with HIE.
Abstract

Keywords:
EpidemiologyFollow-Up StudiesNeonatology

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