Influence of the early intervention on mental and psychological development in infants with hypoxic-ischemic encephalopathy

Jianhui SONG; Rang HUANG; Yujia YANG; Jing LIU; Zhen LUO

ABSTRACT

BACKGROUND:

Perinatal hypoxic-ischemic encephalopathy(HIE) is the primary cause of neonatal brain injury, which retards the mental development in affected infants.

OBJECTIVE:

To investigate the influence of early intervention on mental and psychological development in infants with HIE, study the time-effect relation of the early intervention, and to find an optimal time for intervention.

DESIGN:

A time series of following-up and a non-randomized concurrent controlled investigation.

SETTING:

Xiangya Hospital and Xiangya School of Medicine Affiliated to Central South University.

PARTICIPANTS:

From February 1999 to May 2001, in the Pediatric Department of Xiangya Hospital Affiliated to the Central South University, the inpatient and outpatient infants with HIE were selected. There were 32 inpatients in the intervention group, 10 with moderate HIE and 22 with severe HIE. There were 36 outpatients in the control group, 10 with moderate HIE and 26 with severe HIE. Comparison was performed between these two groups.

METHODS:

BRS and the Infant and Child Mental Development Scales,made by The Institute of Psychology of The Chinese Academy of Science and The China National Children' s Center(CNCC), were adopted in the assessment between the two groups.MAIN OUTCOME

MEASURES:

Mental Development Index(MDI) and Psychomotor Development Index(PDI) scores of the two groups were compared.were significantly higher in the intervention group(90.50 ± 11.12/90. 34±12.49,94.06±14.96/92.03±13.07,90.78±7.46/91.38 ± 13.87)than those in the control group(62.28±7.44/62.67±6.06, 59.11following-up results showed that one patient in the intervention group had a MDI score at the critical threshold value, and two patients had PDI scores at the critical threshold value. For all the other patients in this group, the MDI/PDI scores of them were above the moderate range. In contrast, all the 36 infants in control group had developed mental deficiencies at that time.

CONCLUSION:

A quantifiable effect of the intervention can be observed in patients at 3 months of life. This indicates that an early intervention is essential for improving the mental development in infants with HIE.