Kim Annink

72 Chapter 4 ABSTRACT Background: Hypoxic-ischemic encephalopathy (HIE) is an important cause of morbidity and mortality in neonates. When the gold standard MRI is not feasible, cerebral ultrasound (CUS) might offer an alternative. In this study, the association between a novel CUS scoring system and neurodevelopmental outcome in neonates with HIE was assessed. Methods: (Near-)term infants with HIE and therapeutic hypothermia, with a CUS on day one and day three to seven after birth and available outcome data were retrospectively included in cohort I. CUS findings on day one and day three to seven were related to adverse outcome in univariate and the CUS of day three to seven also in multivariable logistic regression analyses. The resistance index, the sum of deep grey matter and of white matter involvement were included in multivariable logistic regression analyses. A comparable cohort from another hospital was used for validation (cohort II). Results: Eighty-three infants were included in cohort I and 35 in cohort II. The final CUS scoring system contained the sum of white matter (OR=2.6, 95%CI 1.5-4.7) and deep grey matter involvement (OR=2.7, 95%CI 1.7-4.4). The CUS scoring system performed well in cohort I (AUC=0.90) and II (AUC=0.89). Conclusion: This validated CUS scoring system is associated with neurodevelopmental outcome in neonates with HIE.