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Master Thesis

Devenir à l'âge scolaire des enfants ayant présenté une encéphalopathie anoxo ischémique néonatale

Abstract : Purpose: to describe the neurological and cognitive outcomes at school age of term infants with post asphyxia neonatal encephalopathy and to investigate neonatal prognostic factors : predictive factors of disabilities or predictive factors of favorable outcome. Patients and methods: we conducted a clinical and neuropsychological assessment at 6 years of age on children who had had a hypoxic ischemic neonatal encephalopathy (NE). We used the WPPSI III for assessing their general intelligence (IQ). The other cognitive functions (attentional, executive and visuospatial functions, memory, praxis, sensorimotor function, language) were measured by certain tests of the NEPSY and the KABC-2. Results: 38 newborns were included in our study. 5 children died during neonatal hospitalization. Among the survivors, 67% were followed up by a neonatologist until 18/24 months and only 30% until the preschool age (4/5 years). In our study, we found 39,5 % with adverse outcomes and 60,5% with favorable outcomes. The proportion of infants with adverse outcomes was nil in stage I (mild NE), 47 % in stage II (moderate NE), and 100 % in stage III (severe NE) according to the SARNAT and SARNAT grading. The perinatal characteristics significantly (p<0,05) associated with an adverse outcome were: -a severe metabolic acidosis measured in the first hour of life, -an entrance in a neonatal intensive care after the sixth hour of life, -an abnormal neurological examination at the end of the first week of life an abnormal EEG at the end of the first week of life, -an abnormal cerebral MRI. Concluded: Our results are comparable to data from the literature. The stages I and III according to the SARNAT and SARNAT grading are strong prognostic factors. The other prognostic factors have a lower predictive value but are very important for the stage II which has an uncertain prognosis. All the children with post asphyxia neonatal encephalopathy must receive a long acting follow up until school age with a neuropsychological assessment when they are 4/5 years.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00880019
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Submitted on : Tuesday, November 5, 2013 - 11:35:55 AM
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Amélie Darleguy-Pili. Devenir à l'âge scolaire des enfants ayant présenté une encéphalopathie anoxo ischémique néonatale. Médecine humaine et pathologie. 2013. ⟨dumas-00880019⟩

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