Table 3.
Demographic, Perinatal and Clinical Details
| Mild NE | Moderate NE | Severe NE | Post-Hoc Analysis | |||||
|---|---|---|---|---|---|---|---|---|
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| Demographics | (n=48) | (n=35) | (n=6) | p value |
Mild v Moderat |
Mild v Sever |
Moderate v Severe |
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| Gestation (weeks) | 39.5 (38.6–40.4) | 38.8 (37.4–40.4) | 38.6 (37.3–40.5) | 0.53 | ||||
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| Birth Weight (gm) | 3268 (2968–3548) | 3245 (2810–3555) | 3247 (2775–3835) | 0.98 | ||||
|
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| Birth wt <10%ile | 6 (12%) | 3 (8%) | 0 | 0.38 | ||||
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| Sex (M/F) | 26/22 (54/46) | 19/16 (54/46) | 5/1 (83/17) | 0.38 | ||||
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| Inborn | 29 (60) | 22 (63) | 4 (67) | 0.9 | ||||
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| Method of Delivery | 0.17 | |||||||
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| SVD | 13 (27) | 9 (26) | 2 (33) | |||||
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| Instrumental | 11 (23) | 2 (6) | 0 | |||||
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| Emergent Cesarean | 24 (50) | 24 (69) | 4 (67) | |||||
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| Perinatal Data | ||||||||
|
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| Resuscitation required | 41 (85) | 31 (89) | 6 (100) | 0.6 | ||||
|
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| Perinatal event | 22 (47) | 16 (46) | 4 (67) | 0.63 | ||||
|
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| First pH | 7.09 (6.98–7.27) | 7.08 (6.96–7.22) | 6.93 (6.66–7.06) | 0.17 | ||||
|
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| First BE | −11.2 (−6.0 to −14.5) | −12.5 (−7.8 to −17.4) | −14.9 (−7.0 to −24.4) | 0.22 | ||||
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| Highest Lactate | 4.5 (2.6–7.9) | 5.9 (2.7–10.3) | 5.7 (3.8–13.9) | 0.32 | ||||
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| Apgar at 10 min < 5 | 6 (13) | 9 (26) | 3 (50) | 0.17 | ||||
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| PPV Required at 10 min | 11 (23) | 14 (40) | 6 (100) | 0.001 | 0.15 | <0.001 | 0.009 | |
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| aEEG± Applied (n) | 36 | 27 | 5 | 0.001 | 0.18 | <0.001 | 0.03 | |
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| Normal/Mild | 26 (72) | 14 (52) | 2 (40) | |||||
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| Moderate | 9 (25) | 10 (37) | 0 | |||||
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| Severe | 1 (3) | 3 (11) | 3 (60) | |||||
|
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| Age at NE Exam (hr) | 4 (2–5) | 2.5 (1–4) | 2 (1.9–3.1) | 0.007 | 0.004 | 0.87 | 0.051 | |
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| Timing of MRI scans | ||||||||
|
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| First MRI- Day of life | 4 (4–5) | 4 (3–5) | 4 (2–7) | 0.72 | ||||
|
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| First MRI- PMA (week) | 40.1 (39.0–40.9) | 39.2 (37.6–40.8) | 39.1 (37.6–41.1) | 0.39 | ||||
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| Second MRI- Day of life | 12 (9–14) | 13 (10–17) | 11 (9–13) | 0.28 | ||||
|
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| Second MRI- PMA (week) | 40.9 (39.1–41.9) | 41.3 (38.7–42.3) | 39.9 (37.1–40.0) | 0.25 | ||||
|
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| Short Term Outcome | ||||||||
|
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| Anemia | 3 (7) | 3 (9) | 1 (17) | 0.02 | 1.0 | 0.4 | 0.5 | |
|
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| Leukopenia | 1 (2) | 2 (6) | 1 (17) | 0.48 | ||||
|
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| Thrombocytopenia | 13 (29) | 17 (52) | 2 (33) | 0.19 | ||||
|
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| Highest PT recorded | 17 (16–18) | 19 (17–21) | 20 (17–23) | 0.05 | 0.037 | 0.09 | 0.52 | |
|
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| Highest INR recorded | 1.4 (1.3–1.5) | 1.5 (1.4–1.8) | 1.7 (1.4–2.1) | 0.04 | 0.032 | 0.08 | 0.47 | |
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| Highest PTT recorded | 44 (38–52) | 51 (42–61) | 52 (44–74) | 0.09 | ||||
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| Received Blood Product | 8 (17) | 16 (46) | 6 (100) | <0.001 | 0.004 | <0.001 | 0.02 | |
|
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| PRBC | 2 (4) | 8 (23) | 3 (50) | 0.004 | 0.01 | 0.007 | 0.3 | |
|
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| Platelets | 2 (4) | 8 (23) | 2 (33) | 0.03 | 0.01 | 0.06 | 0.6 | |
|
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| FFP or Cryoprecipitate | 6 (13) | 12 (34) | 5 (83) | <0.001 | 0.017 | 0.001 | 0.06 | |
|
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| Major hemorrhage‡ | 0 | 1 | 1 | 0.07 | ||||
|
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| Significant arrhythmia | 0 | 0 | 0 | 1.0 | ||||
|
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| Fat necrosis | 1 | 1 | 0 | 0.95 | ||||
|
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| Ventilated | 8 (17) | 13 (37) | 6 (100) | <0.001 | 0.007 | <0.001 | 0.006 | |
|
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| Duration of ventilation | 0 (0–8) | 0 (0–12) | 7 (1–13) | <0.001 | 0.033 | <0.001 | 0.002 | |
|
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| (days)† | ||||||||
|
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| Required Inotrope | 1 (2) | 8 (23) | 3 (50) | 0.001 | 0.003 | 0.003 | 0.3 | |
|
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| Seizures | 8 (17) | 8 (23) | 4 (67) | 0.057 | ||||
|
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| Clinical only | 2 | 6 | 2 | |||||
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| Electro-clinical | 5 | 2 | 1 | |||||
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| Electrical only | 1 | 0 | 0 | |||||
|
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| Time of 1st seizure (HOL) | 10.5 (6–52) | 1.6 (1–13) | 2 (1–4) | |||||
|
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| AED at discharge | 3 (6) | 2 (6) | 1 (17) | 0.76 | ||||
|
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| Achieved full enteral | 6 (5–7) | 7 (5–9) | 6 (4–6) | 0.13 | ||||
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| feeds (days) | ||||||||
|
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| NG/GT feed at discharge | 0 | 0 | 2 (33) | <0.001 | ||||
|
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| Length of stay (days) | 8 (6–12) | 11 (7–13) | 11 (5–33) | 0.24 | ||||
|
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| Death | 0 | 2 (6) | 1 (17) | 0.11 | ||||
Data are displayed as median (IQR),
(Min –Max), n (%). Analysis across groups were performed using a Kruskall-Wallis H Test or Chi Squared. For Post-Hoc analysis Mann Whitney U test or Fisher’s exact test were used, as appropriate. A Bonferroni correction was applied to post-hoc analysis, for which significance was taken as p <0.016
± not all infants had an aEEG- applied in 36 infants with mild NE, 27 with moderate NE, and 5 with severe NE
Definitions: SVD- spontaneous vaginal delivery, BE- Base excess, PMA- post-menstrual age, PRBC- packed red blood cells, FFP- Fresh frozen plasma, AED- Antiepileptic medications, NG- Nasogastric tube, GT- Gastric Tube, Thrombocytopenia- platelet count <150000, Anemia- hematocrit <30, Leucopenia- white blood cell count<5 × 109, Major hemorrhage - bleeding necessitating immediate transfusion of product, Perinatal event- uterine rupture, shoulder dystocia, cord prolapse or fetal bradycardia