Multimodal Outcome at 7 Years of Age after Neonatal Arterial Ischemic Stroke

Objectives To evaluate the epileptic, academic, and developmental status at age 7 years in a large population of term-born children who sustained neonatal arterial ischemic stroke (NAIS), and to assess the co-occurrence of these outcomes. Study design A cohort study including 100 term newborns with NAIS was designed. Two infants died during the neonatal period, 13 families were lost to follow-up, and 5 families declined to participate in this evaluation. Thus, 80 families completed the 7-year clinical assessment. Epileptic status, schooling, motor abilities, global intellectual functioning, spoken language, and parental opinions were recorded. Principal component analysis was applied. Results Rates of impaired language, cerebral palsy, low academic skills, active epilepsy, and global intellectual deficiency were 49%, 32%, 28%, 11%, and 8%, respectively. All were highly correlated. Eventually, 59% of children were affected by at least 1 of the aforementioned conditions. In 30% of cases, the viewpoints of health practitioners and parents did not match. Conclusion The prevalence of severe disabilities at 7 years after NAIS is low, but most children exhibit some impairment in developmental profile. Trial registration ClinicalTrials.gov (NCT02511249), Programme Hospitalier de Recherche Clinique Regional (0308052), Programme Hospitalier de Recherche Clinique Interregional (1008026), and EudraCT (2010-A00329-30).