THE VALUE OF A SCORING SYSTEM FOR HYPOXIC-ISCHEMIC ENCEPHALOPATHY IN PREDICTING NEURODEVELOPMENTAL OUTCOME

A numeric scoring system for the assessment of hypoxic ischaemic encep halopathy during the neonatal period was tested. The value of the scor e in predicting neurodevelopmental outcome at 1 y of age was assessed. Forty-five infants who developed hypoxic ischaemic encephalopathy aft er birth were studied prospectively. In addition to the hypoxic ischae mic encephalopathy score all but two infants had at least one cranial ultrasound examination. Thirty-five infants were evaluated at 12 month s of age by full neurological examination and the Griffiths Scales of Mental Development. Five infants were assessed at an earlier stage, fo ur who died before 6 months of age and one infant who was hospitalized at the time of the 12 month assessment. Twenty-three (58%) of the inf ants were normal and 17 (42%) were abnormal, 16 with cerebral palsy an d one with developmental delay. The hypoxic ischaemic encephalopathy s core was highly predictive for outcome. The best correlation with outc ome was the peak score; a peak score of 15 or higher had a positive pr edictive value of 92% and a negative predictive value of 82% for abnor mal outcome, with a sensitivity and specificity of 71% and 96%, respec tively. For the clinician working in areas where sophisticated technol ogy is unavailable this scoring system will be useful for assessment o f infants with hypoxic ischaemic encephalopathy and for prognosis of n eurodevelopmental outcome.