Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome

Inge A Zonnenberg, R Jeroen Vermeulen, Maartje W Rohaan, Mirjam M van Weissenbruch, Floris Groenendaal, Linda S de Vries

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND AND OBJECTIVE: Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce.

METHODS: Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14-35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development.

RESULTS: Eighteen patients (37%) died during the neonatal period. In 25 patients MRI was performed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28%), whereas some form of white matter injury was present in 16 (64%) and a combination in 3 (12%). Follow-up data were available for 26 patients (84% of survivors). Formal assessment of neurodevelopmental outcome was performed in 20 of 31 (65%) infants who survived (median age: 19 months, range: 14-35). Sixteen infants (80%) had a developmental quotient appropriate for age in the first 2 years after birth. On motor outcome, 1 patient (5%) scored below average (Z-score -1.10). One patient developed cerebral palsy.

CONCLUSION: Early neurodevelopmental outcome in surviving patients with severe neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospectively collected data with a longer follow-up period are needed.

Original languageEnglish
Pages (from-to)282-288
Number of pages7
JournalNeonatology
Volume109
Issue number4
DOIs
Publication statusPublished - 2016

Cite this

Zonnenberg, Inge A ; Vermeulen, R Jeroen ; Rohaan, Maartje W ; van Weissenbruch, Mirjam M ; Groenendaal, Floris ; de Vries, Linda S. / Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome. In: Neonatology. 2016 ; Vol. 109, No. 4. pp. 282-288.
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abstract = "BACKGROUND AND OBJECTIVE: Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce.METHODS: Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14-35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development.RESULTS: Eighteen patients (37{\%}) died during the neonatal period. In 25 patients MRI was performed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28{\%}), whereas some form of white matter injury was present in 16 (64{\%}) and a combination in 3 (12{\%}). Follow-up data were available for 26 patients (84{\%} of survivors). Formal assessment of neurodevelopmental outcome was performed in 20 of 31 (65{\%}) infants who survived (median age: 19 months, range: 14-35). Sixteen infants (80{\%}) had a developmental quotient appropriate for age in the first 2 years after birth. On motor outcome, 1 patient (5{\%}) scored below average (Z-score -1.10). One patient developed cerebral palsy.CONCLUSION: Early neurodevelopmental outcome in surviving patients with severe neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospectively collected data with a longer follow-up period are needed.",
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Zonnenberg, IA, Vermeulen, RJ, Rohaan, MW, van Weissenbruch, MM, Groenendaal, F & de Vries, LS 2016, 'Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome' Neonatology, vol. 109, no. 4, pp. 282-288. https://doi.org/10.1159/000443320

Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome. / Zonnenberg, Inge A; Vermeulen, R Jeroen; Rohaan, Maartje W; van Weissenbruch, Mirjam M; Groenendaal, Floris; de Vries, Linda S.

In: Neonatology, Vol. 109, No. 4, 2016, p. 282-288.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome

AU - Zonnenberg, Inge A

AU - Vermeulen, R Jeroen

AU - Rohaan, Maartje W

AU - van Weissenbruch, Mirjam M

AU - Groenendaal, Floris

AU - de Vries, Linda S

N1 - © 2016 The Author(s) Published by S. Karger AG, Basel.

PY - 2016

Y1 - 2016

N2 - BACKGROUND AND OBJECTIVE: Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce.METHODS: Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14-35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development.RESULTS: Eighteen patients (37%) died during the neonatal period. In 25 patients MRI was performed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28%), whereas some form of white matter injury was present in 16 (64%) and a combination in 3 (12%). Follow-up data were available for 26 patients (84% of survivors). Formal assessment of neurodevelopmental outcome was performed in 20 of 31 (65%) infants who survived (median age: 19 months, range: 14-35). Sixteen infants (80%) had a developmental quotient appropriate for age in the first 2 years after birth. On motor outcome, 1 patient (5%) scored below average (Z-score -1.10). One patient developed cerebral palsy.CONCLUSION: Early neurodevelopmental outcome in surviving patients with severe neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospectively collected data with a longer follow-up period are needed.

AB - BACKGROUND AND OBJECTIVE: Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce.METHODS: Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14-35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development.RESULTS: Eighteen patients (37%) died during the neonatal period. In 25 patients MRI was performed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28%), whereas some form of white matter injury was present in 16 (64%) and a combination in 3 (12%). Follow-up data were available for 26 patients (84% of survivors). Formal assessment of neurodevelopmental outcome was performed in 20 of 31 (65%) infants who survived (median age: 19 months, range: 14-35). Sixteen infants (80%) had a developmental quotient appropriate for age in the first 2 years after birth. On motor outcome, 1 patient (5%) scored below average (Z-score -1.10). One patient developed cerebral palsy.CONCLUSION: Early neurodevelopmental outcome in surviving patients with severe neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospectively collected data with a longer follow-up period are needed.

KW - Severe neonatal anaemia

KW - MRI findings

KW - Neurodevelopmental outcome

U2 - 10.1159/000443320

DO - 10.1159/000443320

M3 - Article

VL - 109

SP - 282

EP - 288

JO - Neonatology

JF - Neonatology

SN - 1661-7800

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ER -