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Factors affecting early childhood growth in hypoxic-ischemic encephalopathy treated with hypothermia

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Abstract

Introduction

There is an extensive body of research regarding neurological outcomes following neonatal hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH), with limited data on growth outcomes. We examined perinatal characteristics associated with postnatal growth in this population.

Methods

Convenience cohort of 66 infants with HIE who underwent TH and participated in follow-up at 24 months of age were included. Regression modeling including perinatal anthropomorphics, markers of HIE, and systemic injury was used to evaluate growth at 24 months.

Results

Birth head circumference was associated with weight (p = 0.036). MRI severity, pH at admission and birth head circumference were associated with height (p = 0.043, p = 0.015 and p = 0.043 respectively). MRI severity and length of intubation were associated with head circumference (p = 0.038 and p < 0.001 respectively).

Conclusion

There was a significant association between specific early factors and growth at 24 months among infants with HIE treated with TH.

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Fig. 1: MRI NICHD grade is significantly associated with head circumference at 24 months.
Fig. 2: Birth head circumference in neonates with HIE significantly predicts weight at 24 months.
Fig. 3: MRI NICHD grade significantly predicts height at 24 months.

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Data availability

The dataset of which this paper is based is a small pilot sample and is not retained or publicly archived.

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Acknowledgements

We acknowledge the members of the Johns Hopkins Neurosciences Intensive Care Nursery whose collaboration has provided a platform for this research. We are particularly grateful to the participants and their families without whom this research would not be possible.

Funding

Vera Joanna Burton was supported by the NINDS/NIH K12-NS001696 during data collection for this project. Vera Joanna Burton, Gwendolyn Gerner, Frances Northington and Raul Chavez-Valdez were all supported in part by NIH/NICHD 1 R01 HD086058-01A1 during the preparation of this manuscript.

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Authors and Affiliations

  1. Kennedy Krieger Institute, Department of Neurology and Developmental Medicine, Baltimore, MD, USA

    Srishti Jayakumar, Vera Joanna Burton, Daniella Asafu-Adjaye, Frances Northington, Raul Chavez-Valdez, Mary Leppert, Marilee Allen & Gwendolyn Gerner

  2. Neurosciences Intensive Care Nursery, Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Srishti Jayakumar, Vera Joanna Burton, Daniella Asafu-Adjaye, Frances Northington, Raul Chavez-Valdez, Mary Leppert, Marilee Allen & Gwendolyn Gerner

  3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Jamie Perin

  4. Frederick Memorial Hospital, Department of Neonatology, Frederick, MD, USA

    Elizabeth Cristofalo

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  1. Srishti Jayakumar
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Contributions

Srishti Jayakumar participated in the data collection for the project, as well as analysis and writing of this manuscript. Vera Joanna Burton participated in the conceptualization and data collection for the project, as well as analysis and writing of this manuscript. Jamie Perin participated in the analysis and reviewed this manuscript. Daniella Asafu-Adjaye participated in data collection for the project and reviewed this manuscript. Elizabeth Cristofalo participated in the conceptualization and data collection for this project and reviewed the manuscript. Frances Northington participated in the conceptualization of this project and reviewed the manuscript. Raul Chavez-Valdez Northington participated in the conceptualization of this project and reviewed the manuscript. Mary Leppert participated in the conceptualization of this project and reviewed the manuscript. Marilee Allen participated in the conceptualization of this project and reviewed the manuscript. Gwendolyn Gerner participated in the conceptualization and data collection for the project, as well as analysis and writing of this manuscript.

Corresponding author

Correspondence to Srishti Jayakumar.

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The authors declare no competing interests.

Statement of ethics

Study approval statement: The study was approved by the Institutional Review Board at Johns Hopkins University School of Medicine (IRB00133750). Written consent was obtained for the use of study participant data. This is not a clinical trial nor did it contain any experiments with animals.

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Jayakumar, S., Burton, V.J., Perin, J. et al. Factors affecting early childhood growth in hypoxic-ischemic encephalopathy treated with hypothermia. J Perinatol 44, 532–538 (2024). https://doi.org/10.1038/s41372-024-01890-x

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