PENGARUH ENSEFALOPATI NEONATAL AKIBAT ASFIKSIA NEONATORUM TERHADAP GANGGUAN PERKEMBANGAN NEUROLOGIS

Abstract

Abstract Background: Neurodevelopmental Disorders is the failure to achieve proper neurologic functional capabilities. One of the causes of Neurodevelopmental Disorders is neonatal encephalopathy caused by neonatal asphyxia which carries a high morbidity and mortality. To date, however, there is no study on early detection of Neurodevelopmental Disorders in children with neonatal encephalopathy caused by neonatal asphyxia. Objective: To evaluate the effect of neonatal encephalopathy caused by neonatal asphyxia on the incidence of Neurodevelopmental Disorders. Method: A prospective cohort study to assess Neurodevelopmental Disorders using Bayley Infant Developmental Screener. Subjects were 40 babies, including 20 with neonatal encephalopathy caused by neonatal asphyxia and 20 with neonatal asphyxia admitted to NICU and High Risk Baby Care Unit of Dr Kariadi Hospital, Semarang, during August 2006 – June 2007. Hypothesis was tested by Chi-square test, RR > 2 was stated as the risk factor. Onset of Neurodevelopmental disorders was determined by Kaplan-Meier survival’s analysis, and the interval between the occurrence of Neurodevelopmental Disorders and neonatal encephalopathy caused by neonatal asphyxia was assessed by log-rank test. Level of significance, p < 0.05 was chosen, with 95% CI. Result: The subjects were 40 babies, boy > girl, with a proportion of 1.22 : 1 (p =0.5). Follow up until 6 months of age found 7 babies with Neurodevelopmental Disorders, including 6 from 20 (30%) babies in the neonatal encephalopathy caused by neonatal asphyxia group and 1 from 20 (5%) control. The distribution of Neurodevelopmental Disorders occurrence between neonatal encephalopathy caused by neonatal asphyxia and control group was significant (p=0.04). Neonatal encephalopathy caused by neonatal asphyxia is a risk factor for neurodevelopmental Disorders, with a relative risk of 8.1 (95%CI=0.9-75.5). Mean survival time of Neurodevelopmental Disorders in control was 6 months, and for the neonatal encephalopathy due to neonatal asphyxia group the value was 5.6 months (p=0.04). Seizure duration (p<0.001), onset (p=0.02) and nutritional status (p=0.002) had an association with the occurrence of Neurodevelopmental Disorders. Conclusion: Neonatal encephalopathy caused by neonatal asphyxia is a causative factor for Neurodevelopmental Disorders. Keywords: Neonatal Encephalopathy, Neonatal Asphyxia, Neurodevelopmental Disorders, Bayley Infant Neurodevelopmental Screener.