{
  "abstract": "Objective To study the school performance of children with hypoxic ischaemic encephalopathy (HIE) relative to population controls from childhood to early adolescence.Design Population-based cohort study.Setting New South Wales, Australia.Patients All 564 159 live-born infants ≥35 weeks’ gestation born between 2008 and 2013 were eligible; 550 with HIE and 558 355 population controls.Exposure Mild, moderate-severe HIE.Main outcome measures National school assessment performance at 8–9, 10–11 and 12–13 years. Secondary outcomes: reading, writing, spelling, grammar and numeracy scores at these ages. Linear regression models estimated the adjusted mean difference (aMD) at each timepoint. Hierarchical growth-curve modelling assessed academic trajectories (adjusted β).Results Children with moderate-severe HIE had significantly lower total z-scores compared with controls at 8–9 years (aMD −0.70; 95% CI −0.84 to –0.52), 10–11 years (aMD −0.96; 95% CI −1.19 to –0.57) and 12–13 years (aMD −0.82; 95% CI −1.12 to –0.53), especially in reading and writing. The gap in overall mean scores remained fixed over time. Despite a lower likelihood of passing each year compared with controls, most infants with moderate-severe HIE passed each year (n=103, 62.4%). Children with mild HIE did not perform significantly differently from controls at 8–9 years (aMD −0.09; 95% CI −0.32 to 0.15), although there was a signal of worsening performance with age (β=13.54; 95% CI –21 to –6.07).Conclusions Children with moderate-severe HIE perform at a lower academic level than their peers, yet most meet national standards up to early adolescence. In contrast, children with mild HIE perform on par with their peers. This information is crucial for families: providing reassurance and a basis for needed support.",
  "authors": [
    {
      "affiliations": [
        "Population Policy and Practice, University College London Institute of Child Health, London, UK"
      ],
      "name": "Philippa Rees"
    },
    {
      "affiliations": [
        "Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Mithilesh Dronavalli"
    },
    {
      "affiliations": [
        "Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK"
      ],
      "name": "Ben Carter"
    },
    {
      "affiliations": [
        "NSW Pregnancy and Newborn Services Network, Sydney Children’s Hospitals Network, St Pauls, New South Wales, Australia"
      ],
      "name": "Barbara Bajuk"
    },
    {
      "affiliations": [
        "National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia"
      ],
      "name": "Lucinda Burns"
    },
    {
      "affiliations": [
        "The Poche Centre for Indigenous Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Michelle Dickson"
    },
    {
      "affiliations": [
        "National Public Health Service, Te Whatu Ora-Health New Zealand, Dunedin, New Zealand",
        "School of Population Health, University of New South Wales, Kensington, New South Wales, Australia"
      ],
      "name": "John Eastwood"
    },
    {
      "affiliations": [
        "Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia",
        "School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Sadia Hossain"
    },
    {
      "affiliations": [
        "Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"
      ],
      "name": "Kate Lawler"
    },
    {
      "affiliations": [
        "Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia",
        "Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia"
      ],
      "name": "Evelyn Lee"
    },
    {
      "affiliations": [
        "Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Sithum Munasinghe"
    },
    {
      "affiliations": [
        "Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Andrew Page"
    },
    {
      "affiliations": [
        "Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, New South Wales, Australia"
      ],
      "name": "Hannah Uebel"
    },
    {
      "affiliations": [
        "Private Practice, Havertown, Pennsylvania, USA"
      ],
      "name": "Lauren Dicair"
    },
    {
      "affiliations": [
        "Alpha Maxx Healthcare, Memphis, Tennessee, USA"
      ],
      "name": "Charles Green"
    },
    {
      "affiliations": [
        "Academic Neonatal Medicine, School of Public Health, Imperial College London, London, UK"
      ],
      "name": "Chris Gale"
    },
    {
      "affiliations": [
        "Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia",
        "School of Women's and Children’s Health, University of New South Wales, Randwick, New South Wales, Australia"
      ],
      "name": "Ju Lee Oei"
    }
  ],
  "title": "School outcomes after HIE: a population-based cohort study",
  "uid": "a31e6fd1-7bf9-5acd-88e6-2d5f5b612ecf"
}