Higher parental education was associated with good cognitive outcomes in infants with hypoxic-ischaemic encephalopathy

ACTA PAEDIATRICA(2024)

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Abstract
AimPredicting neurodevelopmental outcomes in hypoxic-ischaemic encephalopathy (HIE) remains imprecise, despite advanced imaging and neurophysiological tests. We explored the predictive value of socio-economic status (SES).MethodsThe cohort comprised 93 infants (59% male) with HIE, who had received therapeutic hypothermia. Patients underwent magnetic resonance imaging, and brain injuries were quantified using the Barkovich scoring system. Family SES was self-reported using a questionnaire. Adverse outcomes were defined as mild to severely delayed development with a score of <= 85 in any domain at 2 years of age, based on the Bayley Scales of Infant Development, Second Edition. Data are presented as odds ratios (OR) with 95% confidence intervals (95% CI).ResultsMultiple regression modelling revealed that higher parental education was strongly associated with good cognitive development, when adjusted for gestational age, serum lactate and brain injuries (OR 2.20, 95% CI 1.16-4.36). The effect size of parental education (beta = 0.786) was higher than one score for any brain injury using the Barkovich scoring system (beta = -0.356). The literacy environment had a significant effect on cognitive development in the 21 infants who had brain injuries (OR 40, 95% CI 3.70-1352).ConclusionParental education and the literacy environment influenced cognitive outcomes in patients with HIE.
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Key words
hypoxic-ischaemic encephalopathy,magnetic resonance imaging,neurodevelopment,parental education,socio-economic status
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