Impact of Therapeutic Hypothermia on Neurodevelopmental Outcomes in Moderate-to-Severe Neonatal Hypoxic Ischemic Encephalopathy: A Follow-up Study

Objectives: This study explores neurodevelopmental outcome and survival in neonates with stage 2/3 hypoxic ischemic encephalopathy (HIE) (condition of lack of sufficient oxygen to the brain and a diminished amount of blood perfusing the brain) treated with therapeutic hypothermia (TH), highlighting key clinical predictors linked to outcomes using the Ages and Stages Questionnaire: Version 3 (ASQ-3) tool. Methods: This was a descriptive observational study of babies who underwent TH for moderate-to-severe HIE over a period of 18 months. Results: Among 44 outborn neonates treated with TH, 50% were male and 86.4% had a birth weight >2.5 kg. All required resuscitation; 61.4% were intubated. Seizures occurred in 88.6%, and 20.5% were on antiepileptics at 1 year. Coagulopathy was present in 72.7%, and abnormal ABG in 52.3%. Neurosonogram was normal in 29 babies, with 82.8% showing normal outcomes. Hospital stay <48 h after TH was seen in 27 babies, all with normal development. Longer hospital stays were associated with statistically significant abnormal outcomes ( P = 0.001). Of the 44 babies, 27 (61.4%) initiated breastfeeding within 48 h after TH, and all (100%) showed normal neurodevelopmental outcomes. Overall, 35 babies (79.5%) had normal neurodevelopment at 36 months (ASQ-3). Conclusion: TH improves both early and late neurodevelopmental outcomes in infants with moderate-to-severe HIE. Early initiation of breastfeeding and early hospital discharge predict better neurodevelopmental outcomes.