Abstract
Background
Among term and late preterm infants, hypoxic ischemic encephalopathy (HIE) is an important cause of mortality, and neurologic morbidity among survivors.
Objective
The primary objective was to study the incidence of survival to discharge among late preterm and term infants with moderate or severe HIE. Secondary objectives were to explore variation in the management of HIE across participating sites and to identify the predictors of survival.
Setting
Indian Neonatal Collaborative (INNC), a network of 28 neonatal units in India.
Study design
Retrospective cohort.
Participants
Late preterm (34–36 weeks) and term (37–42 weeks) infants with moderate to severe HIE from 2018–2019.
Outcome
The primary outcome was survival to discharge (including discharged home and transfer to other hospital). A multivariate logistic regression model was constructed to identify the predictors of survival.
Results
Of 352 infants with moderate or severe HIE, 59% received therapeutic hypothermia. Survival to discharge among infants with moderate or severe HIE was 82%. Severe HIE (aOR 0.04; 95% CI 0.02–0.10), persistent pulmonary hypertension (PPHN) (aOR 0.22; 95% CI 0.08–0.61) and requirement of epinephrine during resuscitation (aOR 0.21; 95% CI 0.05–0.84) were independently associated with decreased odds of survival to discharge.
Conclusion
Survival to discharge among infants with moderate or severe HIE was 82%. Severe HIE, requirement of epinephrine during resuscitation and PPHN decreased the odds of survival.
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Authors and Affiliations
Contributions
Contributors: CK, NP: conceptualized and designed the study. CK, GP, NP: designed the data collection tools; NP, TPO, ASA, BT, DC, SR, MS, NSK, AAM, SK, BS, SM, PK: coordinated and supervised the data collection at respective centers and interpreted the data. CK, NP: performed the statistical analysis; CK, GP, NP: drafted the initial manuscript; NP, TPO, ASA, SM, PK: critically reviewed the manuscript for important intellectual content. NP and PK revised the final manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
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Ethics declarations
Ethics clearance: The participation in the INNC database was approved by Institutional ethics committee at individual centers. No personal identifiers were retained.
Competing interest: None stated.
Additional information
Note: Supplementary matter related to this article is available at https://www.indianpediatrics.net
Electronic supplementary material
13312_2022_2413_MOESM1_ESM.pdf
Web Table I Admissions and Survival to Discharge Among Individual Centers for Neonates with Hypoxic Ischemic Encephalopathy (N=352)
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Kumar, C., Peruri, G., Plakkal, N. et al. Short-term Outcome and Predictors of Survival Among Neonates With Moderate or Severe Hypoxic Ischemic Encephalopathy: Data From the Indian Neonatal Collaborative. Indian Pediatr 59, 21–24 (2022). https://doi.org/10.1007/s13312-022-2413-9
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DOI: https://doi.org/10.1007/s13312-022-2413-9