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Year :2026
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Month :
April
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Volume :
14
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Issue :
2
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Page :
PO24 - PO28
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Predictive Value of Early Brain MRI for Neurodevelopmental Outcome at 12 Months of Age in Neonates with Hypoxic Ischaemic Encephalopathy: A Prospective Observational Study from a Tertiary Care Centre
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Correspondence Address :
Digvijay Ghangas, Payal Mittal, Shubham Jaglan, Manish Mittal, Trishala, Sonia Bhatt,
Dr. Digvijay Ghangas,
Near Vidya Niketan School Opposite to Police Station Israna, Panipat-132107,
Haryana, India.
E-mail: digvijayghangas@gmail.com
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Introduction: Perinatal asphyxia with Hypoxic Ischaemic Encephalopathy (HIE) is a common cause of neonatal mortality and morbidity in Low and Middle Income Countries (LMIC) including India. Early objective assessment of severity of brain injury in these neonates is vital in important prognostication and timely optimisation of early intervention. Early Magnetic Resonance Imaging (MRI) is a tool commonly used to predict neurodevelopmental outcome in these neonates, however, studies are limited to assess this association in the Indian context.
Aim: To determine the association between early MRI brain findings and neurodevelopmental outcome at 12 months of age in neonates with HIE.
Materials and Methods: This prospective observational study was conducted in neonatal intensive care unit FH Medical College and Hospital, Agra, Uttar Pradesh, India. A total of 123 babies admitted with diagnosis of perinatal asphyxia by National Neonatal-Perinatal Database (NNPD) criteria were enrolled between October 2020 to September 2023. HIE staging was done by Sarnat and Sarnat staging. MRI was done at 7 to 14 days of life. Neonates were assessed for anthropometry, neurological examination and a DDST-II (Denver Developmental screening- II) at 12 months of age. Normally distributed continuous variables were summarised as Mean±SD and compared using Analysis of Variance (ANOVA). Categorical variables were analysed using the Chi-square test, and correlations were assessed using Pearson’s correlation coefficient and p-value <0.05 was significant.
Results: Out of total 123 participants, 93 (75.6%) were male. A total of 91 (74%) deliveries were vaginal, while 32 (26%) were performed by caesarean section. Of 123, 101 (82%) babies completed the follow-up and DDST-2 was done at 12 month. Correlation of MRI brain with developmental screening was done at 12 months of age showed 100% sensitivity, 51.5% specificity with Positive Predictive Value (PPV) 55% and Negative Predictive Value (NPV) of 100%.
Conclusion: In neonates with HIE, increasing severity was strongly associated with abnormal MRI findings, worse neurological status at discharge, and delayed neurodevelopment at 12 months. Abnormal MRI was common in HIE stage II-III and predicted poor outcomes, while normal MRI was associated with normal development. So MRI is a reliable prognostic tool.
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