Incidence and prediction of outcome in hypoxic-ischemic encephalopathy in Japan

Masahiro Hayakawa, Yushi Ito, Shigeru Saito, Nobuaki Mitsuda, Sigeharu Hosono, Hitoshi Yoda, Kazutoshi Cho, Katsufumi Otsuki, Satoshi Ibara, Katsuo Terui, Kouji Masumoto, Takeshi Murakoshi, Akihito Nakai, Mamoru Tanaka, Tomohiko Nakamura

Research output: Contribution to journalArticle

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Abstract

Background Hypoxic-ischemic encephalopathy (HIE) is one of the most critical pathologic conditions in neonatal medicine due to the potential for neurological deficits in later life. We investigated the incidence of term infants with moderate or severe HIE in Japan and identified prognostic risk factors for poor outcome in HIE. Methods Data on 227 infants diagnosed with moderate or severe HIE and born between January and December 2008 were collected via nationwide surveys from 263 responding hospitals. Using logistic regression, we examined the relationship between maternal, antepartum, intrapartum, and neonatal risk factors and clinical outcome at 18 months following birth. Results In Japan, the incidence of moderate or severe HIE was 0.37 per 1000 term live births. Outborn births, low Apgar score at 5 min, use of epinephrine, and low cord blood pH were intrapartum factors significantly associated with neurodevelopmental delay and death at 18 months. Serum lactate, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase (all, P < 0.001) and creatine kinase (P = 0.002) were significantly higher in infants with poor outcome compared to those with favorable outcomes. Abnormal brain magnetic resonance imaging (MRI), an important prognostic factor, was significantly associated with poor outcome (odds ratio, 11.57; 95% confidence interval: 5.66-23.64; P < 0.001). Conclusions Risk factors predicting poor outcome in HIE include outborn birth, low Apgar score at 5 min, use of epinephrine, laboratory abnormalities, and abnormal MRI findings.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalPediatrics International
Volume56
Issue number2
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Brain Hypoxia-Ischemia
Japan
Incidence
Apgar Score
Parturition
Epinephrine
Magnetic Resonance Imaging
Term Birth
Live Birth
Creatine Kinase
Aspartate Aminotransferases
Alanine Transaminase
Fetal Blood
L-Lactate Dehydrogenase
Lactic Acid
Logistic Models
Odds Ratio
Mothers
Medicine
Confidence Intervals

Keywords

  • hypoxic-ischemic encephalopathy
  • magnetic resonance imaging
  • neurodevelopmental outcome
  • risk factor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Hayakawa, M., Ito, Y., Saito, S., Mitsuda, N., Hosono, S., Yoda, H., ... Nakamura, T. (2014). Incidence and prediction of outcome in hypoxic-ischemic encephalopathy in Japan. Pediatrics International, 56(2), 215-221. https://doi.org/10.1111/ped.12233

Incidence and prediction of outcome in hypoxic-ischemic encephalopathy in Japan. / Hayakawa, Masahiro; Ito, Yushi; Saito, Shigeru; Mitsuda, Nobuaki; Hosono, Sigeharu; Yoda, Hitoshi; Cho, Kazutoshi; Otsuki, Katsufumi; Ibara, Satoshi; Terui, Katsuo; Masumoto, Kouji; Murakoshi, Takeshi; Nakai, Akihito; Tanaka, Mamoru; Nakamura, Tomohiko.

In: Pediatrics International, Vol. 56, No. 2, 2014, p. 215-221.

Research output: Contribution to journalArticle

Hayakawa, M, Ito, Y, Saito, S, Mitsuda, N, Hosono, S, Yoda, H, Cho, K, Otsuki, K, Ibara, S, Terui, K, Masumoto, K, Murakoshi, T, Nakai, A, Tanaka, M & Nakamura, T 2014, 'Incidence and prediction of outcome in hypoxic-ischemic encephalopathy in Japan', Pediatrics International, vol. 56, no. 2, pp. 215-221. https://doi.org/10.1111/ped.12233
Hayakawa, Masahiro ; Ito, Yushi ; Saito, Shigeru ; Mitsuda, Nobuaki ; Hosono, Sigeharu ; Yoda, Hitoshi ; Cho, Kazutoshi ; Otsuki, Katsufumi ; Ibara, Satoshi ; Terui, Katsuo ; Masumoto, Kouji ; Murakoshi, Takeshi ; Nakai, Akihito ; Tanaka, Mamoru ; Nakamura, Tomohiko. / Incidence and prediction of outcome in hypoxic-ischemic encephalopathy in Japan. In: Pediatrics International. 2014 ; Vol. 56, No. 2. pp. 215-221.
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abstract = "Background Hypoxic-ischemic encephalopathy (HIE) is one of the most critical pathologic conditions in neonatal medicine due to the potential for neurological deficits in later life. We investigated the incidence of term infants with moderate or severe HIE in Japan and identified prognostic risk factors for poor outcome in HIE. Methods Data on 227 infants diagnosed with moderate or severe HIE and born between January and December 2008 were collected via nationwide surveys from 263 responding hospitals. Using logistic regression, we examined the relationship between maternal, antepartum, intrapartum, and neonatal risk factors and clinical outcome at 18 months following birth. Results In Japan, the incidence of moderate or severe HIE was 0.37 per 1000 term live births. Outborn births, low Apgar score at 5 min, use of epinephrine, and low cord blood pH were intrapartum factors significantly associated with neurodevelopmental delay and death at 18 months. Serum lactate, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase (all, P < 0.001) and creatine kinase (P = 0.002) were significantly higher in infants with poor outcome compared to those with favorable outcomes. Abnormal brain magnetic resonance imaging (MRI), an important prognostic factor, was significantly associated with poor outcome (odds ratio, 11.57; 95{\%} confidence interval: 5.66-23.64; P < 0.001). Conclusions Risk factors predicting poor outcome in HIE include outborn birth, low Apgar score at 5 min, use of epinephrine, laboratory abnormalities, and abnormal MRI findings.",
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AU - Ito, Yushi

AU - Saito, Shigeru

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AU - Hosono, Sigeharu

AU - Yoda, Hitoshi

AU - Cho, Kazutoshi

AU - Otsuki, Katsufumi

AU - Ibara, Satoshi

AU - Terui, Katsuo

AU - Masumoto, Kouji

AU - Murakoshi, Takeshi

AU - Nakai, Akihito

AU - Tanaka, Mamoru

AU - Nakamura, Tomohiko

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N2 - Background Hypoxic-ischemic encephalopathy (HIE) is one of the most critical pathologic conditions in neonatal medicine due to the potential for neurological deficits in later life. We investigated the incidence of term infants with moderate or severe HIE in Japan and identified prognostic risk factors for poor outcome in HIE. Methods Data on 227 infants diagnosed with moderate or severe HIE and born between January and December 2008 were collected via nationwide surveys from 263 responding hospitals. Using logistic regression, we examined the relationship between maternal, antepartum, intrapartum, and neonatal risk factors and clinical outcome at 18 months following birth. Results In Japan, the incidence of moderate or severe HIE was 0.37 per 1000 term live births. Outborn births, low Apgar score at 5 min, use of epinephrine, and low cord blood pH were intrapartum factors significantly associated with neurodevelopmental delay and death at 18 months. Serum lactate, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase (all, P < 0.001) and creatine kinase (P = 0.002) were significantly higher in infants with poor outcome compared to those with favorable outcomes. Abnormal brain magnetic resonance imaging (MRI), an important prognostic factor, was significantly associated with poor outcome (odds ratio, 11.57; 95% confidence interval: 5.66-23.64; P < 0.001). Conclusions Risk factors predicting poor outcome in HIE include outborn birth, low Apgar score at 5 min, use of epinephrine, laboratory abnormalities, and abnormal MRI findings.

AB - Background Hypoxic-ischemic encephalopathy (HIE) is one of the most critical pathologic conditions in neonatal medicine due to the potential for neurological deficits in later life. We investigated the incidence of term infants with moderate or severe HIE in Japan and identified prognostic risk factors for poor outcome in HIE. Methods Data on 227 infants diagnosed with moderate or severe HIE and born between January and December 2008 were collected via nationwide surveys from 263 responding hospitals. Using logistic regression, we examined the relationship between maternal, antepartum, intrapartum, and neonatal risk factors and clinical outcome at 18 months following birth. Results In Japan, the incidence of moderate or severe HIE was 0.37 per 1000 term live births. Outborn births, low Apgar score at 5 min, use of epinephrine, and low cord blood pH were intrapartum factors significantly associated with neurodevelopmental delay and death at 18 months. Serum lactate, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase (all, P < 0.001) and creatine kinase (P = 0.002) were significantly higher in infants with poor outcome compared to those with favorable outcomes. Abnormal brain magnetic resonance imaging (MRI), an important prognostic factor, was significantly associated with poor outcome (odds ratio, 11.57; 95% confidence interval: 5.66-23.64; P < 0.001). Conclusions Risk factors predicting poor outcome in HIE include outborn birth, low Apgar score at 5 min, use of epinephrine, laboratory abnormalities, and abnormal MRI findings.

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