Role of Citicoline in Neonates with Hypoxic-Ischaemic Encephalopathy.

OBJECTIVE: To evaluate the short-term neurological outcomes in neonates with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE) treated with citicoline. STUDY DESIGN: A randomised controlled trial. Place and Duration of the Study: Department of Paediatrics, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from 2024 to 2025. METHODOLOGY: Seventy neonates presenting with moderate or severe HIE, according to the Sarnat scoring system, were enrolled. Participants were allocated into two equal groups (n = 35 each) by using a simple randomisation method. The citicoline-treated group received citicoline in addition to routine care, while the control group received only routine care. Clinical outcomes were compared. Data were analysed using the chi-square test for qualitative variables and the Student's t-test for quantitative variables. A p-value of <0.05 was considered statistically significant. RESULTS: Out of 70 neonates, 37 (52.8%) were female, while 33 (47.2%) were male. In the citicoline-treated group, the mean duration of NICU stay was 6.23 ± 3.42 days, compared with 8.46 ± 3.26 days in the control group (p = 0.007). Furthermore, the suck and Moro reflexes were established significantly earlier than the control group, with p-values of 0.001 and 0.002, respectively. CONCLUSION: This study demonstrated the neuroprotective effects of citicoline in the treatment of HIE in neonates, with statistically significant earlier establishment of suck and Moro reflexes in the citicoline-treated group compared with the control group. KEY WORDS: Citicoline, Hypoxic-ischaemic encephalopathy, Neonates, Seizures, Suck reflex.