• Athina Pappas, Seetha Shankaran, Scott A McDonald, Betty R Vohr, Susan R Hintz, Richard A Ehrenkranz, Jon E Tyson, Kimberly Yolton, Abhik Das, Rebecca Bara, Jane Hammond, Rosemary D Higgins, and Hypothermia Extended Follow-up Subcommittee of the Eunice Kennedy Shriver NICHD Neonatal Research Network.
• Department of Pediatrics, Wayne State University, Detroit, Michigan; apappas@med.wayne.edu.
• Pediatrics. 2015 Mar 1;135(3):e624-34.

ObjectivesTo describe the spectrum of cognitive outcomes of children with and without cerebral palsy (CP) after neonatal encephalopathy, evaluate the prognostic value of early developmental testing and report on school services and additional therapies.MethodsThe participants of this study are the school-aged survivors of the National Institute of Child Health and Human Development Neonatal Research Network randomized controlled trial of whole-body hypothermia. Children underwent neurologic examinations and neurodevelopmental and cognitive testing with the Bayley Scales of Infant Development-II at 18 to 22 months and the Wechsler intelligence scales and the Neuropsychological Assessment-Developmental Neuropsychological Assessment at 6 to 7 years. Parents were interviewed about functional status and receipt of school and support services. We explored predictors of cognitive outcome by using multiple regression models.ResultsSubnormal IQ scores were identified in more than a quarter of the children: 96% of survivors with CP had an IQ <70, 9% of children without CP had an IQ <70, and 31% had an IQ of 70 to 84. Children with a mental developmental index <70 at 18 months had, on average, an adjusted IQ at 6 to 7 years that was 42 points lower than that of those with a mental developmental index >84 (95% confidence interval, -49.3 to -35.0; P < .001). Twenty percent of children with normal IQ and 28% of those with IQ scores of 70 to 84 received special educational support services or were held back ≥1 grade level.ConclusionsCognitive impairment remains an important concern for all children with neonatal encephalopathy.Copyright © 2015 by the American Academy of Pediatrics.

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