Prediction of underweight, short stature, and microcephaly based on brain diffusion-weighted imaging sequence in neonates with stage.۲ of hypoxic-ischemic encephalopathy: A follow-up study

Background: Hypoxic-ischemic encephalopathy (HIE), caused due to reduced oxygenation and brain blood flow, occurs in ۱-۸ per ۱۰۰۰ live full-term births in developed countries and up to ۲۶ per ۱۰۰۰ live in the developing world. The growth status of survivors of birth HIE has not been evaluated sufficiently. Objective: This study evaluated, the growth parameters (weight, height, and head circumference) of neonates with Sarnat stage.۲ of HIE at ۶, ۱۰, and ۱۲ months and its relationship with findings of neonatal brain diffusion-weighted imaging (DWI) sequence. Materials and Methods: Medical records and growth parameters of ۳۵ neonates with gestational age > ۳۴ wk who were admitted with stage.۲ of HIE in Neonatal Intensive Care Unit of Shahid Sadoughi hospital, Yazd, Iran from March ۲۰۲۱-March ۲۰۲۲, and its relationship with neonatal brain DWI sequence finding was evaluated. Results: ۱۵ girls and ۲۰ boys with a mean birth weight of ۲۸۸۰.۳ ± ۲۲۱.۸ gr were evaluated. Conventional magnetic resonance imaging and DWI were found to be abnormal in ۶ (۱۷.۱%) and ۱۸ neonates (۵۱.۴%). The most abnormal finding of DWI was high signal in basal ganglia/thalamus in ۹ neonates (۲۵.۷%). Abnormal DWI is more frequent in neonates with seizures and low birth weight. Hospital stay days were more prolonged in neonates with abnormal DWI. Microcephaly at ۱۲ months was more frequent in children with abnormal DWI. Conclusion: In survivors of moderate neonatal HIE, abnormal brain DWI sequence might predict inappropriate head growth, and need close medical and nutritional interventions for growth improvement.

Keywords:

Hypoxic ischemia encephalopathy , Magnetic resonance imaging , Diffusion weighted imaging , Microcephaly , Underweight. , هایپوکسیک ایسکمیک انسفالوپاتی , تصویربرداری رزونانس مغناطیسی , تصویربرداری با وزن انتشار , میکروسفالی , کم وزنی.