Early language delay among infants with hypoxic-ischaemic encephalopathy after therapeutic hypothermia: A prospective cohort study.

AIM: To assess early language development in infants with hypoxic-ischaemic encephalopathy (HIE), treated with therapeutic hypothermia (TH) who survived without functional motor deficits, and to identify potential neonatal predictive markers for early language delay (ELD).

METHODS

In a prospective cohort study, 77 infants with HIE treated with TH were recruited. Cognitive development was assessed using the Bayley Scales of Infant Development, Second Edition, and language development using the MacArthur-Bates Communicative Development Inventory in follow-up studies at a median age of 20 months.

RESULTS

Thirty-two (41 %) infants had favorable cognitive and language development (FCLD group), 19 (25 %) exhibited ELD despite good cognitive skills, and 26 (34 %) showed concomitant adverse cognitive and language development (ACLD group). Despite differences in cognitive outcomes, the language profiles of the ELD and ACLD groups were comparable. No early clinical, socioeconomical, or MRI markers predicted language delay. However, maternal education was strongly associated with cognitive outcomes. Compared with maternal university education, infants of mothers with high school education had 3.9-fold higher odds (95 % CI 1.08-13.97) of adverse cognitive outcomes, and those with maternal elementary school education had 10.2-fold higher odds (95 % CI 2.56-40.31).

CONCLUSION

One-third of infants with HIE demonstrated favorable cognitive outcomes but concurrent early language delay, highlighting the need for linguistic screening to prevent later learning disorders. Longitudinal studies are warranted to determine whether ELD infants eventually catch up or remain at risk for persistent language deficits.