Comparison of Long-Term Outcomes of Combined Hypothermia and Whole Body Cooling Therapy in Newborns with Hypoxic-Ischemic Encephalopathy

Therapeutic hypothermia is widely used as a neuroprotective intervention in infants with hypoxic-ischemic encephalopathy (HIE); however, limited data exist regarding the long-term neurodevelopmental outcomes of different cooling strategies. The aim of this study is to compare the long-term neurodevelopmental and cognitive outcomes of combined hypothermia (CH) and whole-body cooling (WBC) treatments in children diagnosed with HIE with each other and with a healthy control group without an HIE diagnosis. This retrospective study included a total of 50 children diagnosed with HIE and treated with cooling therapy, who were followed in the Neonatal Intensive Care Unit of Mersin University between 2015 and 2021. Additionally, a control group was formed from healthy children of a similar age group who attended outpatient clinic checkups between these dates and whose archive records were accessible. We used the Wechsler Intelligence Scale for Children-IV (WISC-IV), the Stroop Test, and the Denver II Developmental Screening Test for neurodevelopmental assessments. Neurodevelopmental outcomes were generally found to be similar between the two groups. However, the Full Scale IQ of the CH group was found to be significantly lower compared to the control group. The groups that underwent cooling treatment showed more abnormalities in the Stroop and Denver tests compared to the control group. Although no significant difference was found between the CH and WBC methods in terms of overall results, weak outcomes in some cognitive subdomains in the CH group were noteworthy. Larger sample sizes and prospective studies are needed.