Of 86 asphyxiated full-term neonates with CNS complications admitted to the Intensive Care Unit at the Nagoya City University Hospital, Japan, during a 10 year period (1972-81), 63 (73%) survived the neonatal period. The CNS complications were hypoxic-ischemic encephalalopathy (58), intracranial hemorrhage (27) and brain infarction (1). Of 54 survivors who were followed for 3 to 13 years, 8 (15%) had major handicaps such as cerebral palsy, epilepsy and mental retardation and 5 (9%) had minor CNS abnormalities. Factors predictive of long-term CNS sequelae were: 1) absent Moro-reflex over 6-days, and 2) abnormal neurological signs on discharge.

Each neonate had a 1 min Apgar score of 6 or less, neurological abnormalities including stupor or lethargy, hypotonia, abnormal respirations, jitteriness or seizures, and one or more abnormal findings on laboratory tests such as spinal tap, echoencephalograpy, cerebral angiography, EEG, and CAT scan. [1]

COMMENT: Another method of assessment of neurologic outcome in asphyxiated term infants is by use of serial CK-BB, or creatine kinase brain-type isoenzyme measurement [2]. Serum CK-BB activity, when measured in cord blood and at 6-12 hours of life, correlates with neurologic outcome after severe asphyxia, comparing favorably with CT scanning as a prognostic factor. The mean of elevations in CK-BB in asphyxiated was 4-fold the values obtained in control infants. Normal CK-BB activity was a predictor of good neurologic outcome.