Iranian Journal of Neonatology

Iranian Journal of Neonatology

Follow-up of Neonates with Hypoxic Ischemic Encephalopathy in First Year of Life

Document Type : Original Article

Authors
Raheleh Rafinezhad 1
Tina Loghmani 1
Ezzat Khodashenas 2
Ahmad Shah Farhat 2
Ashraf Mohamadzadeh 2
Hassan Boskabadi 2
Gholamali Maamouri 2
Raheleh Faramarzi 2
Elham Bakhtiari 3
1 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Faculty of medicine, Mashhad University of Medical Science
10.22038/ijn.2025.78016.2510
Abstract
Background: Hypoxic-ischemic encephalopathy (HIE) is a significant cause of developmental delays in infants, carrying profound long-term implications. Early detection of developmental impairments is crucial for improving outcomes. This study aimed to evaluate the developmental status of infants diagnosed with HIE using the Denver II test at one year of age.
Methods: This prospective cohort study was conducted at Ghaem Hospital and Imam Reza Hospital from October 2019 to August 2020. A total of 39 full-term infants diagnosed with HIE were included. The severity of HIE was classified according to the Sarnat clinical staging system (grade 1: mild, grade 2: moderate, grade 3: severe). Developmental outcomes were assessed at one year using the Denver II test, evaluating four domains: gross motor, fine motor, personal-social, and speech development. Developmental delays were classified based on the number and severity of failures in the test.
Results: Of the 39 infants, 87.2% showed normal developmental outcomes at one year, 7.7% were suspected of having developmental delays, 2.6% exhibited mild developmental delays, and 2.6% demonstrated moderate developmental delays. There was no significant association between developmental outcomes and variables such as gestational age, maternal age, parity, or severity of HIE (all p > 0.05). However, the majority of infants with mild and moderate HIE performed normally on the Denver II test, while a smaller proportion of those with severe HIE showed developmental delays.
Conclusion: This study highlights that most infants with HIE, particularly those with mild to moderate forms, achieve normal developmental outcomes by one year of age. However, the presence of developmental delays in a minority of infants with more severe HIE suggests the need for ongoing monitoring. Larger, multi-center studies with longer follow-up are required to better understand the long-term neurodevelopmental trajectories of infants with HIE.
 
Keywords
Developmental delays
Denver II test
Hypoxic-ischemic encephalopathy
Neonatal care
Perinatal asphyxia
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Iranian Journal of Neonatology
Volume 16, Issue 4
Autumn 2025
Pages 12-20