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Resuscitation at Birth Increases Risk for Low IQ

Neonatal resuscitation might contribute more to low IQ than previously appreciated.

Hypoxic encephalopathy after neonatal resuscitation has been associated with subsequent cognitive impairment. To further examine cognitive outcomes after neonatal resuscitation, investigators in the U.K. studied intelligence quotient (IQ) scores at a mean age of 8 years in 5953 children who were born after 36 weeks’ gestation and who were enrolled in a longitudinal cohort study. Overall, 426 infants had been resuscitated, 26 of whom had had symptoms of encephalopathy.

Compared with children who had not been resuscitated, children who had been resuscitated had significantly increased risk for low IQ scores (<80) at age 8 years. After adjustment for potentially confounding risk factors, risk for low IQ was elevated in resuscitated children with symptoms of encephalopathy (odds ratio, 6.22) and resuscitated children without symptoms of encephalopathy (OR, 1.65). Mean IQ scores among resuscitated children without encephalopathy were modestly but significantly lower than scores among children who had not been resuscitated. The population-attributable risk fraction for low IQ was 3.4% in resuscitated infants without symptoms of encephalopathy and 1.2% in resuscitated infants with symptoms of encephalopathy.

Comment: We usually don’t obtain a specific history for resuscitation at birth unless a child is admitted to a neonatal intensive care unit. These findings suggest that neonatal resuscitation is a risk factor for low IQ and might contribute to a previously underappreciated proportion of children with low IQ.

— F. Bruder Stapleton, MD

Published in Journal Watch Pediatrics and Adolescent Medicine June 3, 2009

Citation(s):

Odd DE et al. Resuscitation at birth and cognition at 8 years of age: A cohort study. Lancet 2009 May 9; 373:1615.

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