Early neurodevelopmental outcome in newborns with mild hypoxic-ischaemic encephalopathy

To describe the natural history of newborn children with mild hypoxic-ischaemic encephalopathy in the first year of life.

This was a multicentre, prospective observational study involving five neonatal intensive care units in an Italian region using both structured clinical and neurophysiological assessments according to the Italian Society of Neonatology guidelines. To make the clinical evaluation homogeneous at each centre, a training neurological courses was provided to all operators involved in the study. Forty newborn children (23 males and 17 females) underwent neonatal and infant neurological examination (Hammersmith Neonatal Neurological Examination and Hammersmith Infant Neurological Examination), brain magnetic resonance at 7 to 10 days, electroencephalogram between 6 months and 12 months, and Griffiths Scales of Child Development, Third Edition to assess neurodevelopmental outcome at 12 months.

All of these infants demonstrated typical neuromotor development and age-appropriate developmental quotients at 12 months, even in the few showing abnormalities at magnetic resonance imaging assessment or neurological assessment during the neonatal period.

Current classifications of mild hypoxic-ischaemic encephalopathy may misclassify risk, highlighting the need for refined diagnostic criteria and early staging tools that can be used within the first 6 hours of life.