Clinical predictors of outcome in hypoxic ischaemic encephalopathy in term neonates

Thirty-eight full-term infants with hypoxic ischaemic encephalopathy were followed up prospectively to determine simple predictors of outcome at 1 year. Three predictors of outcome, based on clinical examination alone, were evaluated. These were presence of seizures, grading of encephalopathy and neurobehavioural assessment at discharge from the hospital. Development was assessed using the Bayley scales of infant development, and a mental and motor quotient below 85 was considered to be delayed development. At 1 year, 15 infants showed delayed development; five of them had cerebral palsy. Predictive values were determined for each indicator. Seizures per se did not affect the outcome. All infants with mild encephalopathy were normal. The predictive value of moderate-to-severe encephalopathy was 50%. Abnormal neurobehaviour at the age of 7 days or at discharge, if earlier, was found to be the best predictor of outcome with a predictive value of 91.6%.