Association Between Increased Seizures During Rewarming After Hypothermia for Neonatal Hypoxic Ischemic Encephalopathy and Abnormal Neurodevelopmental Outcomes at 2-Year Follow-up

• DOI: 10.1001/jamaneurol.2021.3723
• Publication Date: 2021-10-20T21:37:08Z
• Authors: Lina F. Chalak; Athina Pappas; Sylvia Tan; Abhik Das; Pablo J. Sánchez; Abbot R. Laptook; Krisa P. Van Meurs; Seetha Shankaran; Edward F. Bell; Alexis S. Davis; Roy J. Heyne; Claudia Pedroza; Brenda B. Poindexter; Kurt Schibler; Jon E. Tyson; M. Bethany Ball; Rebecca Bara; Cathy Grisby; Gregory M. Sokol; Carl T. D’Angio; Shannon E. G. Ham...; Kevin C. Dysart; C. Michael Cotten; William E. Truog; Kristi L. Watterberg; Christopher J. Timan; Meena Garg; Waldemar A. Carlo; Rosemary D. Higgins; ; Namasivayam Ambal...; Monica V. Collins; Shirley S. Cosby; Myriam Peralta-Ca...; Vivien A. Phillips; David A. Randolph; Barbara Alksninis; Robert T. Burke; Melinda Caskey; Nicholas Guerina; Angelita M. Hensman; Martin Keszler; Mary Lenore Keszler; Andrea M. Knoll; Emilee Little; Elizabeth C. McGowan; William Oh; Birju A. Shah; Ross Sommers; Elisa Vieira; Betty R. Vohr; Stephanie Guilford; Satyan Lakshminru...; Anne Marie Reynolds; Michael G. Sacilo...; Ashley Williams; Karen Wynn; Anna Maria Hibbs; Nancy S. Newman; Bonnie S. Siner; Eileen K. Stork; Michele C. Walsh; Arlene Zadell; Michael S. Caplan; Richard A. Polin; Sally S. Adams; Luc P. Brion; Lijun Chen; Alicia Guzman; Elizabeth T. Heyne; Lizette E. Lee; Linda A. Madden; Emma Ramon; Pablo J. Sánchez; Catherine Twell B...; Diana M. Vasil; Myra H. Wyckoff; Patricia L. Ashley; Joanne Finkle; Kimberley A. Fisher; Ronald N. Goldberg; Ricki F. Goldstein; Sandra Grimes; Kathryn E. Gustafson; William F. Malcolm; Ira Adams-Chapman...; Diane I. Bottcher; David P. Carlton; Sheena L. Carter; Ellen C. Hale; Yvonne C. Loggins; Colleen Mackie; Ravi M. Patel; Barbara J. Stoll; Lynn Wineski; Susan Gunn; Heidi M. Harmon; Dianne E. Herron; Abbey C. Hines; Jeffery Joyce; Carolyn Lytle; Lucy C. Miller; Heike M. Minnich; Lu-Ann Papile; Brenda B. Poindexter; Leslie Richard; Lucy C. Smiley; Leslie Dawn Wilson; Michael J. Acarregui; Vipinchandra Bhavsar; Jane E. Brumbaugh; Tarah T. Colaizy; John M. Dagle; Diane L. Eastman; Karen J. Johnson; Jonathan M. Klein; Julie B. Lindower; Steven J. McElroy; Cary R. Murphy; Glenda K. Rabe; Robert D. Roghair; Jeffrey L. Segar; Jacky R. Walker; John A. Widness; Dan L. Ellsbury; Cheri Gauldin; Anne M. Holmes; Kathy Johnson; Howard W. Kilbride; Eugenia K. Pallotto; Allison Scott; Roopali Bapat; Thomas Bartman; Elizabeth Bonachea; Helen Carey; Michelle Chao; Louis G. Chicoine; Bronte Clifford; Marliese Dion Nist; Erin Fearns; Christine A. Fortney; Aubry Fowler; Jennifer Fuller; Jennifer L. Groth...; Ish Gulati; Julie Gutentag; Cole D. Hague; Krista Haines; Brandon Hart; Michael Hokenson; Sudarshan R. Jadc...; Marissa E. Jones; Sarah A. Keim; Patricia Luzader; Nathalie L. Maitre; Sarah McGregor; Pamela Moorehead; Leif D. Nelin; Mary Ann Nelin; Nehal A. Parikh; Elizabeth Rodgers; Ruth Seabrook; Tiffany Sharp; Edward G. Shepherd; Jonathan L. Slaug...; Melanie Stein; Rox Ann Sullivan; Jodi A. Ulloa; Jon Wispe; Tara Wolfe; Keith O. Yeates; Lina Yossef-Salameh; Nahla Zaghoul; Stephanie Wilson ...; Soraya Abbasi; Judy C. Bernbaum; Aasma S. Chaudhary; Dara M. Cucinotta; Sara B. DeMauro; Marsha Gerdes; Hallam Hurt; Haresh Kirpalani; Toni Mancini; Barbara Schmidt; Kyle Binion; Patrick Conway; Osman Farooq; Ronnie Guillet; Cassandra A. Horihan; Rosemary L. Jensen; Nirupama Laroira; Joan Merzbach; Gary J. Myers; Premini Sabaratnam; Ann Marie Scorsone; Holly I.M. Wadkins; Kelley Yost; Carla M. Bann; Margaret M. Crawford; Jenna Gabrio; Marie G. Gantz; Scott A. McDonald; Jamie E. Newman; Jeanette O’Donnel...; Carolyn M. Petrie...; James W. Pickett; Annie M. VonLehmden; Dennis Wallace; Kristin M. Zaterk...; Valerie Y. Chock; Maria Elena DeAnda; Anne M. DeBattista; Lynne C. Huffman; Casey E. Krueger; Ryan E. Lucash; Melinda S. Proud; David K. Stevenson; Heather L. Taylor; Hali E. Weiss; Teresa Chanlaw; Uday Devaskar; Rachel Geller; Isabell B. Purdy; Sofia Aliaga; Janice Bernhardt; Carl L. Bose; Cynthia L. Clark; Matthew Maxwell L...; Diane D. Warner; Janice Kay Weresz...; Conra Backstrom Lacy; Andrea F. Duncan; Janell Fuller; Carol H. Hartenbe...; Jean R. Lowe; Robin K. Ohls; Sandra Sundquist ...; John Barks; Mary K. Christensen; Stephanie A. Wiggins; Monika Bajaj; Sanjay Chawla; Kirsten Childs; Lilia C. De Jesus; Eunice Hinz Woldt; Mary E. Johnson; Girija Natarajan; Bogdan Panaitescu; Jeannette E. Pren...; Beena G. Sood
• Keywords: Neonatal Encephalopathy; Burst suppression; Hypoxic-Ischemic Encephalopathy

Compared with normothermia, hypothermia has been shown to reduce death or disability in neonatal hypoxic ischemic encephalopathy but data on seizures during rewarming and associated outcomes are scarce. To determine whether electrographic more likely occur compared the preceding period they abnormal asphyxiated neonates receiving therapy. This prespecified nested cohort study of infants enrolled Optimizing Cooling (OC) multicenter Eunice Kennedy Shriver National Institute Child Health Human Development (NICHD) Neonatal Research Network trial from December 2011 2013 2 years' follow-up randomized either 72 hours cooling (group A) 120 B). The main included 364 infants. Of these, 194 were screened, 10 declined consent, met all predefined inclusion criteria. A total 112 (90%) had complete for disability. Data analyzed January 2018 2020. Serial amplitude electroencephalography recordings 12 prior evidence seizure activity by central amplitude-integrated readers blinded treatment arm epoch. Odds ratios 95% CIs evaluated following adjustment center, seizures, depth cooling, severity. primary outcome was occurrence initiated at 12-hour Secondary moderate severe age 18 22 months. hypothesis that higher odds neurodevelopmental outcomes. newborns (70 male [58%]) (66 group 54 mean (SD) gestational 39 (1) weeks. There excellent interrater agreement (κ, 0.99) detection seizures. More epoch A, 27% vs 14%; P = .001; B, 21% 10%; .03). Adjusted odd (95% CIs) frequency 2.7 (1.0-7.5) 3.2 (0.9-11.6) B. composite years significantly (relative risk [95% CI], 1.7 [1.25-2.37]) after adjusting baseline clinical as well center. Findings highlight necessity monitoring risk. ClinicalTrials.gov Identifier: NCT01192776.