Cognitive functions after neonatal encephalopathy in a coastal city of South India-A retrospective cohort study

Background: Cognitive impairment either with presence or absence of neuromotor disability is a pertinent issue after neonatal encephalopathy (NE). Aims and objectives: To assess motor and cognitive functions in survivors of NE and to correlate them with NE clinical scoring/staging. Methodology: A hospital based retrospective cohort study was conducted at a tertiary teaching medical college hospital. Medical records were studied and survivors of term neonates with NE that were managed in the neonatal intensive care unit (NICU) were considered as cases. Children born as term babies during the same period requiring no intensive care were taken as controls. A onetime follow up of study subjects at 6 – 8 years of age was carried out to assess the motor and cognitive function by standard tests. Data was entered and analyzed by SPSS Version 11. Results: As per Millers encephalopathy scores, majority (52.6%) had an encephalopathy score of one. Seventeen (89.5%) cases were found to be normal by Gross Motor Function Classification System (GMFCS). By Bender Gestalt II visual motor and visual perception tests, five (26.3%) cases and nine (47.4%) cases were in the 0-25 percentile for age respectively. The difference in mean IQ level between cases and controls was significant statistically (p<0.001). The mean values of Malins verbal and performance tests, IQ, Bender copy and recall tests between cases and controls with the encephalopathy scores showed statistical significance(p<0.05). Conclusions: Children who had suffered NE had significant affection of IQ, visual-motor, visual perception and memory in comparison to controls. Greater the encephalopathy score, greater was the cognitive impairment.