Clinics in perinatology
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Clinics in perinatology · Jun 1993
ReviewLong-term follow-up of term neonates with perinatal asphyxia.
Available evidence shows adverse sequelae do not follow perinatal asphyxia unless encephalopathy is part of the neonatal clinical presentation. Where neonatal encephalopathy follows evidence of late fetal and/or early neonatal distress, the staging of the encephalopathy is useful for determination of prognosis; those with mild encephalopathy do well; those with severe encephalopathy do poorly. We believe this staging could be made more universally useful as an outcome variable for study of the etiology and timing of perinatal hypoxic-ischemic injury as well as for prediction of long-term outcome, if clinical correlates to pathophysiologic hypoxic-ischemic insults were used more broadly as the basis for defining the staging criteria. ⋯ School-aged nondisabled moderate encephalopathy survivors did not show the perceptual-motor delay reported in younger survivors. Overall, tests used to evaluate subtle changes that may relate to perinatal hypoxic-ischemic injury have been inadequate; future studies should include tests of acquisition of new learning, memory, problem solving, and reasoning. Further research is required to define the nature and timing of perinatal insults and the continued function of survivors.