The abbreviation PEP (perinatal encephalopathy) is familiar to many parents of children in the first year of life. Unfortunately, this diagnosis is very common in our country and is actively being made by pediatric neurologists. In addition to the fears and worries of parents due to possible negative prognoses of the child's health, such a diagnosis entails medication, medical withdrawals from vaccinations, a long series of unscheduled neurological examinations and massages.
What is PEP and how dangerous is it for a baby?
Today, the term PEP is not used, as it is outdated. Modern neurology uses the definition of perinatal asphyxia or hypoxic-ischemic perinatal encephalopathy.
The cause of perinatal asphyxia is a lack of oxygen in the blood and/ or a decrease in cerebral blood flow in the fetus before childbirth or a newborn during childbirth or the first hours of life.
In Russia, this diagnosis is given to every 5th infant, while in Europe and North America from 1 to 8 cases per 1000 newborns. There is a huge overdiagnosis.
According to major Western studies, the prognosis of perinatal encephalopathy depends on the severity of the condition, which can be roughly correlated with the Apgar score.
Mild degree (Apgar 6-7 points) – in 97-100% of cases, complete recovery without consequences and without medication.
The average degree (Apgar 4-5 points) – in 20-35% of cases leads to neurological disorders.
Severe degree (Apgar 0-3 points) – extremely high risk of persistent neurological pathology
Thus, if your child's Apgar score was higher than 7 points, there were no complications after birth, the child was discharged from the hospital on time without additional examinations and treatment, the baby develops in accordance with age standards, eats well, gains weight, etc., however, the doctor diagnoses your child with PEP, then the eligibility such a diagnosis is in great doubt.
The appointment of drug therapy in this case (actovegin, cavinton, cinnarizine, encephabol, etc.) is not justified in any way. As mentioned above, studies have shown that 97-100% of patients with an Apgar scale of 6-7 points and a reasonably mild degree of severity of AEP without any drug treatment completely lack any neurological consequences. And in the remaining less than 3% of cases, the changes are minimal and are not manifested by a decrease in IQ, developmental delay, or motor disorders.
If you think that your child may have been given an unjustified diagnosis of PEP and prescribed medication, you should not completely ignore this situation. For the sake of his health, consider an alternative consultation with a pediatric neurologist who is guided by the principles of evidence-based medicine. This will help you make the right decision, avoid taking unnecessary medications, and keep your family calm during such important first months of your baby's life.
At the EMC Children's Clinic, experienced pediatric neurologists are always ready to help children and their parents from the first days of a baby's life, including if the baby was born with low weight and/or perinatal disorders of the nervous system. The clinic's doctors have at their disposal modern equipment for the diagnosis and treatment of small patients according to the standards of world evidence-based medicine (ultrasound of the brain, EEG, CT, MRI, etc.).
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