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Journal of Tropical Pediatrics Advance Access originally published online on July 11, 2008
Journal of Tropical Pediatrics 2009 55(1):8-14; doi:10.1093/tropej/fmn061
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The Hypoxic Ischaemic Encephalopathy Score in Predicting Neurodevelopmental Outcomes Among Infants with Birth Asphyxia at the Muhimbili National Hospital, Dar-es-Salaam, Tanzania*

Sekela D. Mwakyusaa, Karim P. Manjib and Augustine W. Massaweb

aNational AIDS Control Program, Tanzania
bDepartment of Pediatrics, Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania

Correspondence: Karim P. Manji, Department of Pediatrics, Muhimbili University College of Health Sciences, PO Box 65001, Dar-es-Salaam, Tanzania. E-mail <kmanji{at}muchs.ac.tz>.


  Abstract

Hypoxic Ischemic Encephalopathy (HIE) score may be used to predict neurodevelopment outcome in infants with birth asphyxia. A total of 140 infants who had a 5 min Apgar score of <7 at birth had detailed motor and neurodevelopment assessment. Outcome measures were grouped as normal or abnormal with morbidity (convulsions, abnormal muscle tone and delayed development) or death. The positive predictive value (PPV) for mortality was 42.3% for moderate HIE and 93.8% for severe HIE. For severe HIE the PPV was 100%. Thirteen infants had delayed development, the score had PPV of 63.6% for moderate HIE and 100% for severe HIE. The best correlation with outcome was the peak score of 15 or higher had a PPV of 100%. Specificity was found to be 100% and sensitivity of 14%. The HIE scoring system is a useful predictor of neurodevelopment outcome at 6 months of age in a resource poor setting.

Key Words: hypoxic ischemic encephalopathy • scoring system • neonates

*This study was conducted at Muhimbili National Hospital, Maternity Ward and High Risk Clinic, Kalenga Street, Dar-es-Salaam, Tanzania.


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