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J Pediatr. 2011 Mar;158(3):360-5. doi: 10.1016/j.jpeds.2010.09.003. Epub 2010 Oct 20.

Perinatal events and early magnetic resonance imaging in therapeutic hypothermia.

Author information

1
Division of Neonatology, University of California San Francisco, School of Medicine, 533 Parnassus Avenue, U585, Box 0748, San Francisco, CA 94143-0748, USA. bonifacios@peds.ucsf.edu

Abstract

OBJECTIVE:

To compare the association between perinatal events and the pattern and extent of brain injury on early magnetic resonance imaging in newborn infants with and without therapeutic hypothermia for hypoxic-ischemic encephalopathy.

STUDY DESIGN:

We performed a cohort study of 35 treated and 25 nontreated neonates who underwent magnetic resonance imaging. The injury patterns were defined a priori as: normal, watershed, or basal ganglia/thalamus-predominant, as well as a dichotomous outcome of moderate-to-severe versus mild-no injury.

RESULTS:

Neonates with hypothermia had less extensive watershed and basal ganglia/thalamus injuries and a greater proportion had normal imaging. Therapeutic hypothermia was associated with a decreased risk of both basal ganglia/thalamus injury (relative risk, 0.29; 95% CI, 0.10 to 0.81, P = .01) and moderate-severe injury. Neonates with sentinel events showed a decrease in basal ganglia/thalamus-predominant injury and an increase in normal imaging. All neonates with decreased fetal movements had injury, predominantly watershed, regardless of therapeutic hypothermia.

CONCLUSIONS:

These results validate reports of reduced brain injury after therapeutic hypothermia and suggest that perinatal factors are important indicators of response to treatment.

PMID:
20965514
PMCID:
PMC3035732
DOI:
10.1016/j.jpeds.2010.09.003
[Indexed for MEDLINE]
Free PMC Article

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