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Article type: Research Article
Authors: Kodidhi, A.a | Riley, M.b | Vesoulis, Z.b; *
Affiliations: [a] Department of Pediatrics, St. Louis Children’s Hospital, St. Louis, MO, USA | [b] Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
Correspondence: [*] Address for correspondence: Zachary A. Vesoulis, MD MSCI, Department of Pediatrics, Division of Newborn Medicine, Campus Box 8116, 660S. Euclid Ave, St. Louis, MO 63110, USA. Tel.: +1 314 286 1524; E-mail: vesoulis_z@wustl.edu.
Abstract: BACKGROUND:Late preterm (LPT) infants are increasingly treated for hypoxic-ischemic encephalopathy (HIE). However, neurodevelopmental differences of LPT infants may independently influence the neurologic exam and confound care. METHODS:Perinatal and outcome characteristics were extracted along with the worst autonomic and state/neuromuscular/reflex Sarnat components in a cross-section of infants with moderate/severe HIE. Infants were classified as late preterm (LPT, 34–36 weeks) or term (>36 weeks). RESULTS:250 infants were identified, 55 were late preterm. LPT infants had lower mean gestational age and birthweight and greater length of stay (LOS). LPT infants had higher median scores for the Moro and respiratory autonomic components, but no difference in total score. CONCLUSIONS:LPT infants had increased LOS, worse Moro reflex, and respiratory status, but no clinically or statistically significant differences in total Sarnat scores. Although it is important to note the impact of immaturity on the exam, it is unlikely to independently alter management.
Keywords: Hypoxic ischemic encephalopathy, late preterm infant, neonates, neurologic exam, therapeutic hypothermia.
DOI: 10.3233/NPM-230041
Journal: Journal of Neonatal-Perinatal Medicine, vol. 16, no. 4, pp. 693-700, 2023
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