Role of Citicoline in Neonates with Hypoxic-Ischaemic Encephalopathy

To evaluate the short-term neurological outcomes in neonates with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE) treated with citicoline.

A randomised controlled trial. Place and Duration of the Study: Department of Paediatrics, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from 2024 to 2025.

Seventy neonates presenting with moderate or severe HIE, according to the Sarnat scoring system, were enrolled. Participants were allocated into two equal groups (n = 35 each) by using a simple randomisation method. The citicoline-treated group received citicoline in addition to routine care, while the control group received only routine care. Clinical outcomes were compared. Data were analysed using the chi-square test for qualitative variables and the Student's t-test for quantitative variables. A p-value of <0.05 was considered statistically significant.

Out of 70 neonates, 37 (52.8%) were female, while 33 (47.2%) were male. In the citicoline-treated group, the mean duration of NICU stay was 6.23 ± 3.42 days, compared with 8.46 ± 3.26 days in the control group (p = 0.007). Furthermore, the suck and Moro reflexes were established significantly earlier than the control group, with p-values of 0.001 and 0.002, respectively.

This study demonstrated the neuroprotective effects of citicoline in the treatment of HIE in neonates, with statistically significant earlier establishment of suck and Moro reflexes in the citicoline-treated group compared with the control group.

Citicoline, Hypoxic-ischaemic encephalopathy, Neonates, Seizures, Suck reflex.