Resistive index as an early prognostic marker in neonatal hypoxic-ischemic encephalopathy: a prospective observational study

Background: Hypoxic-ischemic encephalopathy (HIE) remains a leading cause of neonatal morbidity and mortality. The resistive index (RI), measured via cranial Doppler ultrasound, has emerged as a potential prognostic marker for early neurological outcomes. This study aims to assess the prognostic value of RI in neonates with HIE. Methods: A prospective observational study was conducted on 110 neonates diagnosed with HIE at a Neonatal Intensive Care Unit (NICU) of Guru Gobindsingh Government Hospital, Jamnagar. RI was measured at 6 and 12 hours of life using Cranial Doppler ultrasound. Data on perinatal risk factors and clinical outcomes were collected. Neurological assessments were performed at 3 and 6 months. Standard statistical tests, including chi-square analysis, were used for data interpretation. Results: A significant association was found between RI values at 6 hours and adverse neurological outcomes at 3 months (χ² = 11.45, p = 0.009) and at 6 months (χ² = 10.89, p = 0.012). Similar associations were observed for RI at 12 hours. Higher RI values correlated with increased mortality and adverse neurodevelopmental outcomes. Conclusions: RI measurement via cranial Doppler ultrasound serves as a valuable early prognostic indicator in neonates with HIE. Routine incorporation of RI assessments in neonatal care protocols may aid in early risk stratification and targeted interventions to improve long-term outcomes.