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Neonatal resuscitation and subtle IQ loss
Perinatal resuscitation, even with apparent immediate full recovery, is a marker for subsequent lowered intelligence. A large UK study of 11 000 babies (36 weeks’ gestation plus) showed, as expected, that those surviving perinatal resuscitation with hypoxic–ischaemic encephalopathy (n = 58, 0.5%) had poor intellectual outcomes. The surprise was that even those making apparent full recoveries following perinatal resuscitation (n = 815, 7.1%) were at greater risk of low IQ than non-resuscitated infants (9.8% vs 6.5%; odds ratio 1.65, 95% confidence interval 1.13 to 2.43, adjusted for confounders). The accompanying editorial suggests future studies should use objective markers such as degree of acidosis, EEG and MRI, rather than clinical assessment of neonatal neurological disorder alone.
Lancet 2009;373:1615–22.
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