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Rohaan a Mirjam M. van Weissenbruch a Floris Groenendaal c Linda S. de Vries cDepartments of a Neonatology and b Child Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, and c Department of Neonatology, Wilhelmina Children’s Hospital/University Medical Center Utrecht, Utrecht, The NetherlandsKey WordsSevere neonatal anaemia · MRI findings ·Neurodevelopmental outcomeAbstract Background and Objective: Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce. Methods: Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14–35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development. Results: Eighteen patients (37%) died during the neonatal period. In 25 patients MRI was per-formed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28%), whereas some form of white matter injury was present in 16 (64%) and a combination in 3 (12%). Follow-up data were available for 26 patients (84% of survivors). Formal assessment of neu-rodevelopmental outcome was performed in 20 of 31 (65%) infants who survived (median age: 19 months, range: 14–35).Sixteen infants (80%) had a developmental quotient appro-priate for age in the first 2 years after birth. On motor out-come, 1 patient (5%) scored below average (Z-score –1.10). One patient developed cerebral palsy. Conclusion: Early neurodevelopmental outcome in surviving patients with se-vere neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospective-ly collected data with a longer follow-up period are needed© 2016 The Author(s)Published by S. Karger AG, BaselIntroductionNeonatal anaemia has a diverse aetiology, and it can cause an acute life-threatening situation through hypovo-laemic shock and hypoxia at birth, as well as through mul-tiple organ failure in the first days of life. During hypovo-laemic shock, redistribution of blood flow occurs and may be preferentially directed to the brain, which possi-bly prevents more severe adverse neurological sequelae. Anaemia may result in encephalopathy, which can be as-sessed using aEEG (amplitude-integrated EEG).Data on MRI findings and neurodevelopmental out-come of survivors of neonatal anaemia are limited. SinceE-Mail karger@karger.com www.karger.com/neo© 2016 The Author(s) Published by S. Karger AG, Basel 1661–7800/16/1094–0282$39.50/0This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any dis-tribution of modified material requires written permission.I.A. ZonnenbergDepartment of Neonatology, VU University Medical Center De Boelelaan 1117 NL–1081 HV Amsterdam (The NetherlandsE-Mail i.zonnenberg@vumc.nlsevere anaemia is often associated with perinatal asphyx-ia, it is hard to distinguish with neuro-imaging whether cerebral injury is due to anaemia or the associated hypox-ia-ischaemia.The aim of this retrospective study is to describe aEEG and MRI findings following severe neonatal anaemia in (near) term infants admitted at a level III neonatal inten-sive care unit, and relate these findings to neurodevelop-mental outcome at approximately 2 years of age.MethodsWe retrospectively collected clinical data from medical records of patients who presented with severe anaemia in the neonatal in-tensive care unit of the VU Medical Center, Amsterdam, or the Wilhelmina Children’s Hospital, University Medical Center, Utrecht, between January 2000 and June 2011. Patients with an initial haemoglobin (Hb) concentration <6.0 mmol/l ([mg/dl] = [mmol/l] ×1.61) and a gestational age ≥36 weeks were eligible for this study.