aEEG Assessment for Short-Term Outcome Prognosis Prediction in Hypoxic-Ischemic Encephalopathy: An 11-Year Experience

Hypoxic-ischemic encephalopathy (HIE) continues to be a predominant cause of morbidity and mortality in neonates. Therapeutic hypothermia (TH) is the only method with proven neuroprotective effects, and the aim of this study was to evaluate the short-term results of patients treated with TH.

Demographic, clinical characteristics, laboratory and aEEG results of patients who received TH treatment with a diagnosis of Stage II or Stage III HIE according to modified Sarnat staging in the Neonatal Intensive Care Unit were analyzed retrospectively.

A total of 101 patients were included in the study. The mean gestational age of the patients was 38.8±1.5 weeks, the mean birth weight was 3215±499.5 g, and 40.6% were female. According to the modified Sarnat staging, 50.5% of the patients were evaluated as Stage II, and the others as Stage III HIE. The most common peripartum risk factors were meconium delivery (25.7%) and prolonged or difficult labor (20.7%). Mortality rates in patients with Stage II and Stage III HIE were 5.9% and 26%, respectively. In one of the patients who died, the 6th-hour aEEG background activity was moderately abnormal, and in 15 patients there was a severely abnormal voltage pattern. Acute kidney injury was found to be the most effective factor in mortality.

In our study, it was concluded that the mortality rate of newborns diagnosed with Stage III HIE was higher, the biggest impact factor on mortality was acute kidney injury, and 6th-hour voltage activity in aEEG monitoring was useful in predicting prognosis.