Encéphalopathie anoxo-ischémique et hypothermie thérapeutique : quels principaux impacts psychologiques pour les parents et les bébés présentant une IRM normale à la sortie de la maternité ?

Aim: This is the first French preliminary study to evaluate the psychological health of parents with infants treated by therapeutic hypothermia for anoxo-ischemic encephalopathy and discharged from the hospital with regular initial progression (MRI and normal outpatient examinations).Materials and method: Seven children, under age two, treated with therapeutic hypothermia for anoxo-ischemic encephalopathy at birth and their parents were met and examined. All the children were discharged from the maternity ward with a normal MRI and a satisfactory clinical examination. The Brunet-Lezine scale was used to measure the children’s psychomotor development, while the parents’ psychological health was evaluated using two adapted scales – the Edinburgh Postnatal Depression Scale and the Perinatal Post-Traumatic Stress Disorder scale – in addition to a semi-structured interview.Results: With the revised Brunet-Lezine scale, the children did not present significant developmental delay (DQ between 98 and 97). However, eight to eighteen months after the event, 50 % of mothers and 25 % of fathers showed pathological scores of post-traumatic stress. The other half of the mothers and 25 % of fathers showed postnatal depression. Interviews uncovered traumatic experiences of delivery; bonding difficulties for the first minutes and days following childbirth; high exposure of fathers; extreme projections about life and death during the hypothermia treatment; and the importance of MRI results and the stay in kangaroo care for reassurance and growing accustomed to the feeling of parenthood. We also found persistent parental concerns six months to one year later despite the absence of disability for their children.Conclusion: Anoxo-ischemic encephalopathy and therapeutic hypothermia are psychological stressors for parents, even in the absence of complications. This study confirms the need for a trusted therapeutic framework during hospitalization. But it also shows the importance of a preventive multidisciplinary follow-up for all families, regardless of the medical outcome. More research is needed to better understand and help families facing these life experiences.