[Analysis of early language development delay in children survived neonatal hypoxic-ischemic encephalopathy without...

Introduction: Data are limited about the detailed cognitive functions (e.g., language development) of children who survived neonatal hypoxic-ischemic encephalopathy without neurological impairment (quality survivors). Objective: A description of the prevalence of early language developmental delay and an examination of the differences in various linguistic indicators in quality survivors of hypoxic-ischemic encephalopathy. Method: Children who survived moderate to severe hypoxic-ischemic encephalopathy and received hypothermia treatment and participated in the developmental follow-up examination at 2 years of age were included in the prospective study conducted between 2017 and 2020. Developmental follow-up assessments utilized the Bayley-II Developmental (Cognitive) Scale, with a score of ≤85 indicating unfavorable cognitive outcomes. Language development was assessed using the MacArthur–Bates Communicative Development Inventory: Words and Sentences Forms. Early language delay was defined as expressive vocabulary falling below the 20th percentile despite average cognitive performance. Results: 50 patients were included in the study. Unfavorable cognitive developmental outcomes were observed in 23/50 (46%) cases, while favorable outcomes occurred in 27/50 (54%) cases. Examination of language development revealed early language delay in 10 children, while 17 exhibited typical language development. The occurrence of early language delay was higher compared to the general population (20% vs. 10–15%). The median (IQR) vocabulary size was 30 [20; 70] words in children with delayed language development, compared to 250 [159; 565] words in those with typical language development (p<0.001). The two groups also differed across all language indicators (e.g., use of morphemes and word combinations). Discussion: Quality survivors of hypoxic-ischemic encephalopathy exhibit a higher prevalence of early language delay compared to the general population. Based on our results, it appears that different levels of language, including the lexical and grammatical levels, are affected in children with hypoxic-ischemic encephalopathy who exhibited early language developmental delay but achieved favorable cognitive developmental outcomes. Conclusion: Our findings highlight the importance of examining domain-specific functions such as language development, even in children with favorable cognitive outcomes, as average cognitive function does not necessarily imply intact language abilities. Orv Hetil. 2025; 166(25): 990–999.