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MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS

Year 2022, Volume: 85 Issue: 3, 397 - 403, 06.07.2022
https://doi.org/10.26650/IUITFD.1085771

Abstract

Objective: Neurodevelopmental follow-up of infants with hypoxic ischemic encephalopathy (HIE) and supporting their development have great importance for the later years of their life. The aim of this study was to evaluate motor development outcomes of children with HIE who have undergone therapeutic hypothermia (TH) in Turkey with an objective assessment and the point of view of the parents, and to compare these two assessment methods.
Materials and Methods: Twenty two cases (11 girls, 11 boys) with HIE who have undergone TH were included. Sixteen (72.7%) of the cases were classified as Sarnat Stage-2, and six (27.3%) of the cases were classified as Sarnat Stage-3. Motor development of the cases were evaluated by the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Parents’views on their children’s development were examined with The Ages and Stages Questionnaire-2 (ASQ-2).
Results: 68.2% (n=15) of the cases had normal motor development, 18.2% (n=4) had mild-moderate motor delay and 13.6% (n=3) had severe motor delay according to the Bayley-III motor scale results. When looking at the sub-areas of motor development, 68.2% (n=15) of the cases had normal gross motor development and 86.4% (n=19) of the cases had normal fine motor development. Additionally, 68.2% (n=15) of the cases demonstrated normal gross motor & fine motor development according to ASQ-2 results. Conclusion: Although there are some parallels in the results of the objective assessments and parental views regarding gross motor development, they differ in terms of fine motor development. However, ASQ-2 can be helpful for follow-up of children with HIE in situations where access to a clinician is limited or difficult and also it can provide an opinion to parents about their children’s development.

References

  • 1. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 2004;89(2):152-5. [CrossRef] google scholar
  • 2. Lai MC. Yang SN. Perinatal hypoxic-ischemic encephalopathy. J Biomed Biotechnol 2011;2011:609813. [CrossRef] google scholar
  • 3. Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu. Türkiye’de Yenidoğan Yoğun Bakım Ünitelerinde İzlenen Hipoksik İskemik Ensefalopatili Olgular, Risk Faktörleri, İnsidans ve Kısa Dönem Prognozları. Cocuk Sagligi Hast Derg 2008;51:123-9. google scholar
  • 4. Akisu M, Kumral A, Canpolat FE. Türk Neonatoloji Derneği Yenidoğan Ensefalopati Rehberi. Turk Arch Pediatr 2018;53(Suppl 1):32-44. google scholar
  • 5. Badr Zahr LK, Purdy I. Brain injury in the infant: the old, the new, and the uncertain. J Neonatal Nurs 2006;20(2):163-75. [CrossRef] google scholar
  • 6. Conway JM, Walsh BH, Boylan GB, Murray DM. Mild Hypoxic-Ischaemic Encephalopathy and Long Term Neurodevelopmental Outcome- A Systematic Review. Early Hum Dev 2018;120:80-7. [CrossRef] google scholar
  • 7. Stoll B. Perinatal and Neonatal Medicine. In: Behrman RE, Kliegman RM ve Jenson HB, editors. Nelson Textbook of Pediatrics (18th.Ed). USA:WB Saunders; 2008.p.93-109. google scholar
  • 8. Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al.Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005;353(15):1574-84. [CrossRef] google scholar
  • 9. Azzopardi D, Brocklehurst P, Edwards D, Halliday H, Levene M, Thoresen M, et al. The TOBY Study. Whole Body Hypothermia fort he treatment of perinatal asphyxial encephalopathy: a randomized controlled trial. BMC Pediatr 2008;8:17. [CrossRef] google scholar
  • 10. Jacobs SEA, Hunt R, Tarnow-Mordi W, Inder T, Davis P. Cooling fornewborns with hypoxicischemic encephalopathy. Cochrane Database Syst Rev 2013;2013(1):CD003311. [CrossRef] google scholar
  • 11. Edwards AD, Brocklehurst P, Gunn AJ, Halliday H, Juszczak E, Levene M, et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ 2010;340:c363. [CrossRef] google scholar
  • 12. Kali GT, Martinez-Biarge, M, Van Zyl J, Smith J, Rutherford M. Therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy had favourable outcomes at a referral hospital in a middle-income country. Acta Paediatr 2016;105(7):806-15. [CrossRef] google scholar
  • 13. Rao R, Trivedi S, Distler A, Liao S, Vesoulis Z, Smyser C, et al. Neurodevelopmental outcomes in neonates with mild hypoxic ischemic encephalopathy treated with therapeutic hypothermia. Am J Perinatol 2019;36(13):1337-43. [CrossRef] google scholar
  • 14. Zonnenberg IA, Koopman C, Van Schie PE, Vermeulen RJ, Groenendaal F, Van Weissenbruch MM. Comparison of psychomotor outcome in patients with perinatal asphyxia with versus without therapeutic hypothermia at 4 years using the Ages and Stages Questionnaire screening tool. Eur J Paediatr Neurol 2016;20(4):545-8. [CrossRef] google scholar
  • 15. Zubcevic S, Heljic S, Catibusic F, Uzicanin S, Sadikovic M, Krdzalic B. Neurodevelopmental follow up after therapeutic hypothermia for perinatal asphyxia. Med Arch 2015;69(6):362-6. [CrossRef] google scholar
  • 16. Akar M, Aydemir Ö, Oğuz ŞS, Erdeve Ö, Aydemir C, Gökmen T, et al. Tüm vücut soğutma yöntemi ile hipotermi uygulanan hipoksik iskemik ensefalopatili yenidoğanların değerlendirilmesi. Turk Arch Pediatr 2011;46(4):286-91. [CrossRef] google scholar
  • 17. Çelik P. Hipoksik İskemik Ensefalopati Nedeniyle Terapötik Hipotermi Uygulanan Bebeklerin Nörogelişimsel Sonuçları. Turk. J Pediatr Dis 2021;15(5):1-6. [CrossRef] google scholar
  • 18. Mackin R, Ben Fadel N, Feberova J, Murray L, Nair A, Kuehn S, et al. ASQ3 and/ or the Bayley-III to support clinicians’ decision making. PLoS One 2017;12(2):1-13. [CrossRef] google scholar
  • 19. Utku Umut G. Bayley-III Bebekler ve Küçük Çocuklar için Gelişim Ölçeği Uygulayıcı Eğitimi Notları. Ankara 2019. google scholar
  • 20. Chalak LF, DuPont TL, Sanchez PJ, Lucke A, Heyne RJ, Morriss MC, et al. Neurodevelopmental outcomes after hypothermia therapy in the era of Bayley-III. Am J Perinatol 2014;34(8):629-33. [CrossRef] google scholar
  • 21. Kapci EG, Kucuker S, Uslu RI. How Applicable Are Ages and Stages Questionnaires for Use With Turkish Children? Hammill Institute on Disabilities Topics Early Child Spec Educ 2010;30(3):176-88. [CrossRef] google scholar
  • 22. Schonhaut L, Pereza M, Armijo I, Maturana A. Comparison between Ages & Stages Questionnaire and Bayley Scales, to predict cognitive delay in school age. Early Hum Dev 2020;141;104933. [CrossRef] google scholar
  • 23. Vanucci RC. Hypoxic-ischemic encephalopathy. Am J Perinatol 2000;17(3):113-20. [CrossRef] google scholar
  • 24. Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischemic encephalopathy. Early Hum Dev 2010;86(6):329-38. [CrossRef] google scholar
  • 25. Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Pediatrics 2001;107(3):480-4. [CrossRef] google scholar
  • 26. Gardiner J, Wagh D, McMichael J, Hakeem M, Rao S. Outcomes of hypoxic ischaemic encephalopathy treated with therapeutic hypothermia using gel packs-Experience for Western Australia. Eur J Paediatr Neurol 2014;18(3):391-8. [CrossRef] google scholar
  • 27. Lakatos A, Kolossvâry M, Szabo M, Jermendy Â, Barta H, Gyebnâr G, et al. Neurodevelopmental effect of intracranial hemorrhage observed in hypoxic ischemic brain injury in hypothermia-treated asphyxiated neonates-an MRI study. BMC Pediatr 2019;19(1):430. [CrossRef] google scholar

TERAPÖTİK HİPOTERMİ TEDAVİSİ ALAN ÇOCUKLARIN MOTOR GELİŞİM SONUÇLARI: EBEVEYN GÖRÜŞLERİ İLE BİRLİKTE

Year 2022, Volume: 85 Issue: 3, 397 - 403, 06.07.2022
https://doi.org/10.26650/IUITFD.1085771

Abstract

Amaç: Hipoksik iskemik ensefalopatili (HİE) bebeklerin nörogelişimsel takibi ve gelişimlerinin desteklenmesi yaşamlarının sonraki yılları için büyük önem taşımaktadır. Bu çalışmanın amacı, terapötik hipotermi (TH) tedavisi alan HİE’li çocukların motor gelişim sonuçlarını objektif bir değerlendirme yöntemi ve ebeveynlerin bakış açısıyla değerlendirmek ve bu iki değerlendirme yöntemini karşılaştırmaktır.
Gereç ve Yöntem: TH tedavisi alan 22 HİE’li (11 kız, 11 erkek) olgu dahil edildi. Olguların 16’sı (%72,7) Sarnat Evre-2, 6’sı (%27,3) ise Sarnat Evre-3 olarak sınıflandırıldı. Olguların motor gelişimleri Bayley Bebek ve Küçük Çocuklar için Gelişim Ölçeği (Bayley-III) ile değerlendirildi. Ebeveynlerin çocuklarının gelişimi ile ilgili görüşleri Erken Gelişim Evreleri Anketi-2 (ASQ-2) ile incelendi.
Bulgular: Bayley-III motor skalasına göre olguların %68,2’sinde (n=15) normal motor gelişim saptanırken; %18,2’sinde (n=4) hafif-orta motor gelişim geriliği ve %13.6’sında (n=3) şiddetli motor gelişim geriliği saptandı. Motor gelişimin alt alanlarına bakıldığında olguların %68,2’sinin (n=15) normal kaba motor gelişimi, %86,4’ünün (n=19) normal ince motor gelişimi olduğu görüldü. Öte yandan ASQ-2 sonuçlarına göre olguların %68,2’si (n=15) normal kaba motor ve ince motor gelişim gösterdiği görüldü.
Sonuç: Objektif değerlendirme sonuçları ile ebeveyn görüşleri kaba motor gelişim açısından paralellik gösterse de ince motor gelişim açısından farklılık göstermektedir. Ancak ASQ-2, bir uzmana erişimin sınırlı veya zor olduğu durumlarda HİE’li çocukların takibinde yardımcı olabilir ve ayrıca ebeveynlerine çocuklarının gelişimi hakkında fikir verebilir.

References

  • 1. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 2004;89(2):152-5. [CrossRef] google scholar
  • 2. Lai MC. Yang SN. Perinatal hypoxic-ischemic encephalopathy. J Biomed Biotechnol 2011;2011:609813. [CrossRef] google scholar
  • 3. Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu. Türkiye’de Yenidoğan Yoğun Bakım Ünitelerinde İzlenen Hipoksik İskemik Ensefalopatili Olgular, Risk Faktörleri, İnsidans ve Kısa Dönem Prognozları. Cocuk Sagligi Hast Derg 2008;51:123-9. google scholar
  • 4. Akisu M, Kumral A, Canpolat FE. Türk Neonatoloji Derneği Yenidoğan Ensefalopati Rehberi. Turk Arch Pediatr 2018;53(Suppl 1):32-44. google scholar
  • 5. Badr Zahr LK, Purdy I. Brain injury in the infant: the old, the new, and the uncertain. J Neonatal Nurs 2006;20(2):163-75. [CrossRef] google scholar
  • 6. Conway JM, Walsh BH, Boylan GB, Murray DM. Mild Hypoxic-Ischaemic Encephalopathy and Long Term Neurodevelopmental Outcome- A Systematic Review. Early Hum Dev 2018;120:80-7. [CrossRef] google scholar
  • 7. Stoll B. Perinatal and Neonatal Medicine. In: Behrman RE, Kliegman RM ve Jenson HB, editors. Nelson Textbook of Pediatrics (18th.Ed). USA:WB Saunders; 2008.p.93-109. google scholar
  • 8. Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al.Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005;353(15):1574-84. [CrossRef] google scholar
  • 9. Azzopardi D, Brocklehurst P, Edwards D, Halliday H, Levene M, Thoresen M, et al. The TOBY Study. Whole Body Hypothermia fort he treatment of perinatal asphyxial encephalopathy: a randomized controlled trial. BMC Pediatr 2008;8:17. [CrossRef] google scholar
  • 10. Jacobs SEA, Hunt R, Tarnow-Mordi W, Inder T, Davis P. Cooling fornewborns with hypoxicischemic encephalopathy. Cochrane Database Syst Rev 2013;2013(1):CD003311. [CrossRef] google scholar
  • 11. Edwards AD, Brocklehurst P, Gunn AJ, Halliday H, Juszczak E, Levene M, et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ 2010;340:c363. [CrossRef] google scholar
  • 12. Kali GT, Martinez-Biarge, M, Van Zyl J, Smith J, Rutherford M. Therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy had favourable outcomes at a referral hospital in a middle-income country. Acta Paediatr 2016;105(7):806-15. [CrossRef] google scholar
  • 13. Rao R, Trivedi S, Distler A, Liao S, Vesoulis Z, Smyser C, et al. Neurodevelopmental outcomes in neonates with mild hypoxic ischemic encephalopathy treated with therapeutic hypothermia. Am J Perinatol 2019;36(13):1337-43. [CrossRef] google scholar
  • 14. Zonnenberg IA, Koopman C, Van Schie PE, Vermeulen RJ, Groenendaal F, Van Weissenbruch MM. Comparison of psychomotor outcome in patients with perinatal asphyxia with versus without therapeutic hypothermia at 4 years using the Ages and Stages Questionnaire screening tool. Eur J Paediatr Neurol 2016;20(4):545-8. [CrossRef] google scholar
  • 15. Zubcevic S, Heljic S, Catibusic F, Uzicanin S, Sadikovic M, Krdzalic B. Neurodevelopmental follow up after therapeutic hypothermia for perinatal asphyxia. Med Arch 2015;69(6):362-6. [CrossRef] google scholar
  • 16. Akar M, Aydemir Ö, Oğuz ŞS, Erdeve Ö, Aydemir C, Gökmen T, et al. Tüm vücut soğutma yöntemi ile hipotermi uygulanan hipoksik iskemik ensefalopatili yenidoğanların değerlendirilmesi. Turk Arch Pediatr 2011;46(4):286-91. [CrossRef] google scholar
  • 17. Çelik P. Hipoksik İskemik Ensefalopati Nedeniyle Terapötik Hipotermi Uygulanan Bebeklerin Nörogelişimsel Sonuçları. Turk. J Pediatr Dis 2021;15(5):1-6. [CrossRef] google scholar
  • 18. Mackin R, Ben Fadel N, Feberova J, Murray L, Nair A, Kuehn S, et al. ASQ3 and/ or the Bayley-III to support clinicians’ decision making. PLoS One 2017;12(2):1-13. [CrossRef] google scholar
  • 19. Utku Umut G. Bayley-III Bebekler ve Küçük Çocuklar için Gelişim Ölçeği Uygulayıcı Eğitimi Notları. Ankara 2019. google scholar
  • 20. Chalak LF, DuPont TL, Sanchez PJ, Lucke A, Heyne RJ, Morriss MC, et al. Neurodevelopmental outcomes after hypothermia therapy in the era of Bayley-III. Am J Perinatol 2014;34(8):629-33. [CrossRef] google scholar
  • 21. Kapci EG, Kucuker S, Uslu RI. How Applicable Are Ages and Stages Questionnaires for Use With Turkish Children? Hammill Institute on Disabilities Topics Early Child Spec Educ 2010;30(3):176-88. [CrossRef] google scholar
  • 22. Schonhaut L, Pereza M, Armijo I, Maturana A. Comparison between Ages & Stages Questionnaire and Bayley Scales, to predict cognitive delay in school age. Early Hum Dev 2020;141;104933. [CrossRef] google scholar
  • 23. Vanucci RC. Hypoxic-ischemic encephalopathy. Am J Perinatol 2000;17(3):113-20. [CrossRef] google scholar
  • 24. Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischemic encephalopathy. Early Hum Dev 2010;86(6):329-38. [CrossRef] google scholar
  • 25. Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Pediatrics 2001;107(3):480-4. [CrossRef] google scholar
  • 26. Gardiner J, Wagh D, McMichael J, Hakeem M, Rao S. Outcomes of hypoxic ischaemic encephalopathy treated with therapeutic hypothermia using gel packs-Experience for Western Australia. Eur J Paediatr Neurol 2014;18(3):391-8. [CrossRef] google scholar
  • 27. Lakatos A, Kolossvâry M, Szabo M, Jermendy Â, Barta H, Gyebnâr G, et al. Neurodevelopmental effect of intracranial hemorrhage observed in hypoxic ischemic brain injury in hypothermia-treated asphyxiated neonates-an MRI study. BMC Pediatr 2019;19(1):430. [CrossRef] google scholar
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Gülsena Utku Umut 0000-0002-2110-1607

Mine Çalışkan 0000-0002-6869-3937

Publication Date July 6, 2022
Submission Date March 10, 2022
Published in Issue Year 2022 Volume: 85 Issue: 3

Cite

APA Utku Umut, G., & Çalışkan, M. (2022). MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS. Journal of Istanbul Faculty of Medicine, 85(3), 397-403. https://doi.org/10.26650/IUITFD.1085771
AMA Utku Umut G, Çalışkan M. MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS. İst Tıp Fak Derg. July 2022;85(3):397-403. doi:10.26650/IUITFD.1085771
Chicago Utku Umut, Gülsena, and Mine Çalışkan. “MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS”. Journal of Istanbul Faculty of Medicine 85, no. 3 (July 2022): 397-403. https://doi.org/10.26650/IUITFD.1085771.
EndNote Utku Umut G, Çalışkan M (July 1, 2022) MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS. Journal of Istanbul Faculty of Medicine 85 3 397–403.
IEEE G. Utku Umut and M. Çalışkan, “MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS”, İst Tıp Fak Derg, vol. 85, no. 3, pp. 397–403, 2022, doi: 10.26650/IUITFD.1085771.
ISNAD Utku Umut, Gülsena - Çalışkan, Mine. “MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS”. Journal of Istanbul Faculty of Medicine 85/3 (July 2022), 397-403. https://doi.org/10.26650/IUITFD.1085771.
JAMA Utku Umut G, Çalışkan M. MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS. İst Tıp Fak Derg. 2022;85:397–403.
MLA Utku Umut, Gülsena and Mine Çalışkan. “MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS”. Journal of Istanbul Faculty of Medicine, vol. 85, no. 3, 2022, pp. 397-03, doi:10.26650/IUITFD.1085771.
Vancouver Utku Umut G, Çalışkan M. MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS. İst Tıp Fak Derg. 2022;85(3):397-403.

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