Neurodevelopmental Outcomes after Hypothermia Therapy in the Era of Bayley-III

BACKGROUND: Bayley-III scales are currently used to evaluate outcomes of term infants following hypothermia therapy, while all prior reported outcomes in this population have used Bayley-II. OBJECTIVE: To determine the incidence of abnormal neurodevelopmental outcomes using Bayley III and the predictive value of MRI in infants who received systemic hypothermia. METHODS: We conducted a prospective cohort study of inborn infants who underwent hypothermia for moderate/severe neonatal encephalopathy from 10/2005–11/2011. RESULTS: 80 newborns underwent hypothermia (incidence of 1/1000). Of the survivors, 89% had Bayley-III performed around 24 months of age. An abnormal outcome using Bayley-III <85 occurred in 50%, while Bayley III <70 occurred in 13%. MRI predicted Bayley III < 85 with sensitivity of 73%, specificity of 84%, PPV of 84%, NPV of 74%. CONCLUSIONS: A Bayley-III 85 cut off identifies a disability rate of 50%, and MRI was predictive of abnormal outcomes. Findings can be useful for counseling of families and planning of future studies using Bayley III.