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Therapeutic hypothermia for NE was linked to declining motor, cognitive, and behavioral outcomes, emphasizing the need for long-term monitoring.  

The study published in June 2025 in the issue of Journal of Pediatrics, researchers compared neurodevelopmental outcomes at 18–24 months, 5–6 years, and 8–10 years in children who received therapeutic hypothermia (TH) for neonatal encephalopathy (NE) following perinatal asphyxia.  

They assessed children with NE treated with TH at 2 level III neonatal intensive care units from January 2008 to December 2015. Neurodevelopment was estimated at 18–24 months (visit 1), 5–6 years (visit 2), and 8–10 years (visit 3). Standardized motor, cognitive, and behavioral assessments were used, and scores were converted into Z-scores. The changes were analyzed across visits using linear mixed modeling (LMM).  

The results showed that 77 children were included in the analysis. Motor Z-scores declined non-linearly over time and were lower in those with reduced total intelligence quotient (IQ) at 8–10 years and deep gray matter (DGM) injury visible on neonatal MRI. Cognitive Z-scores also declined in children with mammillary body abnormalities on neonatal MRI and were significantly lower in those with reduced gestational age and lower socioeconomic status. The Z-scores for internalizing behavioral problems rose linearly across visits [visit 1: median -0.7, interquartile range (IQR) 1.4; visit 2: median -0.5, IQR 1.2; visit 3: median -0.1, IQR 1.5].  

Investigators concluded that motor, cognitive, and behavioral Z-scores declined between ages 2 and 8–10 years in children treated with TH for NE. 

Source: jpeds.com/article/S0022-3476(25)00219-7/fulltext