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156 Teenage Outcome of Being Born at Term With Moderate Neonatal Encephalopathy/Hypoxic Ischaemic Encephalopathy

Background: Population-based, long-term follow-up studies of individuals born at term with moderate neonatal encephalopathy (NE)/hypoxic ischaemic encephalopathy (HIE) are very rare. About 50 % of all such cases are expected to develop unequivocal signs of cerebral palsy (CP). The outcome for those without CP is not well understood.Aims: Assess cognitive functions and behaviour problems in children with moderate NE/HIE but without CP.Methods: The study population comprised all 97 468 children born in Sweden in 1985. Of these, 684 were born at term with an Apgar score of <7 at 5 minutes. These children's obstetric and neonatal records were scrutinized and the children were classified according to degree of NE/HIE. Teenagers with moderate NE/HIE without CP were subjected to a clinical assessment including interviews, neuropsychological tests and assessment of data from medical and psychological records. Age at examination was 16–19 years.Results: 58 children had at least moderate NE/HIE and survived the neonatal period. In this group, 20 had developed CP. Nine of the remaining 38 had parents who declined participation in the study. Of 29 teenagers without CP examined, 21 (75%) had definite cognitive dysfunction. Five had hearing impairments.Conclusion: Of the total NE/HIE group of 58 teenagers, follow-up data was available in 49 subjects and only 8 of these were without dysfunctions. Of those who were considered to be free from impairments such as CP, our study revealed that 72 % had problems that interfered with their daily life situation. Clinical follow-up including assessments of cognitive functions before school start should be considered for all individuals in this high risk group.