Co-occurring Impairments in several domains of Memory following Neonatal Hypoxic-Ischaemic Encephalopathy have Real-life Implications

Background
Neonatal Hypoxic-Ischaemic Encephalopathy (HIE) increases risk for neurodevelopmental impairment. Information on school-age memory function is limited in children who received hypothermia treatment (TH) for neonatal HIE.

Objectives
To evaluate memory function in school-aged children who had neonatal HIE and TH and survived without major neuromotor impairment.

Method
Fifty-one children with neonatal HIE and 41 typically developing (TD) peers participated. At age 6-8 years general cognitive abilities (FSIQ) were assessed with Wechsler Intelligence Scale for Children (WISC-V), immediate and delayed visual and verbal memory with Children’s Memory Scale (CMS), everyday memory with Rivermead Behavioural Memory Test for Children (RBMT-C), working memory with WISC-V. Real-life implications were assessed with Behaviour Rating Inventory for Executive Function (BRIEF; Parent and Teacher). Between group differences were examined and correlations performed to assess associations between memory measures. Relationship maps illustrate co-occurring impairments.

Results
FSIQ was in the normal range for both groups but significantly lower in the HIE group. Children with HIE had significantly more deficits in working memory (20.4% vs 0%), verbal immediate (20.0% vs 2.5%), verbal delayed (17.8% vs 2.5%), visual immediate (28.9% vs 7.5%), and everyday memory (38.8% vs 5.6%). Relationship maps identified more co-occurring clinical/borderline impairments in children with HIE (45.1% vs 4.9%) and more frequent clinical impairments in real-world memory measures.

Conclusion
Despite hypothermia treatment, and with general cognitive abilities in the normal range, children with neonatal HIE are at risk of co-occurring memory impairments, affecting everyday functioning at home and school. Timely identification is important for individually targeted support.