Neonatal encephalopathy ne is a serious condition occurring in 1 to 2 of every live term babies. Outcome of fullterm infants with neonatal encephalopathy of hypoxic ischemic origin is often assessed in infancy or early childhood and data on outcome in childhood and adolescence is limited. Because of this, preventing the oxygen deprivation that causes hie is key. Multifactorial etiology in neonatal encephalopathy. Hypoxic ischaemic encephalopathy queensland health. Neonatal encephalopathy and cerebral palsy, medscape july 3, 2003. These different patterns of injury are related to the severity of later motor and. Intrapartum factors associated with neonatal hypoxic ischemic. The risk of hypoxic ischemic encephalopathy increased with. This study examined perinatal risks factor for ne in uganda. Intrapartum complications with hypoxic brain injury is one of the leading causes of neonatal mortality and longterm impairment morbidity worldwide. Neonatal encephalopathy with group b streptococcal disease.
To prevent oxygen deprivation, medical professionals must closely monitor the health of babies during pregnancy, the birthing process, and the neonatal period. Antepartum and intrapartum factors preceding neonatal. Antepartum risk factors for moderate to severe neonatal hypoxic ischemic. Perinatal hypoxic ischemic encephalopathy hie is an important cause of brain injury in the newborn and can result in longterm devastating consequences. The importance of the intrapartum period risk factors for neonatal arterial ischemic stroke. Perwin waly, specialist of pediatrics and neonatology, diploma of hospital manegment asu, international board certified lactation consultant at nicu. Antepartum and intrapartum risk factors in infants. Antepartum and intrapartum factors preceding neonatal hypoxic ischemic encephalopathy. Hypoxicischemic encephalopathy preterm, term, and adult. Encephalopathy due to hypoxicischemic injury hypoxicischemic encephalopathy hie is defined as brain injury caused by the combination of inadequate blood flow and oxygen delivery to the brain.
Hypoxic ischemic encephalopathy hie is the sub cohort of ne that appears to be driven by intrapartum events. Early cranial ultrasound findings among infants with neonatal. To determine whether antepartum factors alone, intrapartum factors alone, or both in combination, are associated with term neonatal hypoxic ischemic encephalopathy hie. Research article open access intrapartum factors associated with neonatal hypoxic ischemic encephalopathy. Study design antepartum and intrapartum data were collected at presentation from 79 infants with nais and compared with 239 controls and 405 infants with hie. Objective neonatal encephalopathy ne is the third leading cause of child mortality.
Placental, inflammatory and genetic factors have all been suggested to have a role in the pathogenesis. Intrapartum factors associated with neonatal hypoxic. Criteria used in term infants to support a diagnosis of hie occur for other. Badawi et al, intrapartum risk factors for newborn encephalopathy. Perinatal risk factors for neonatal encephalopathy. Nulliparity, previous cesarean delivery, short stature, overweight.
Encephalopathy due to hypoxic ischemic injury hypoxic ischemic encephalopathy hie is defined as brain injury caused by the combination of inadequate blood flow and oxygen delivery to the brain. Our objective was to identify antepartum and intrapartum factors associated with the development of. Many factors predispose to the onset of neonatal encephalopathy either alone or in a combination including a preconception risk factors. To determine whether antepartum factors alone, intrapartum factors alone, or both in combination, are associated with term neonatal hypoxicischemic encephalopathy hie.
Apr 11, 2016 neonatal encephalopathy ne is a leading cause of neonatal mortality and morbidity worldwide affecting more than one million infants around the world each year 1,2. Hypoxicischemic encephalopathy hie, and subsequent morbidity and mortality, is seldom reported in preterm infants. Antepartum and intrapartum factors preceding neonatal hypoxic ischemic. Factors associated with severe hypoxic ischemic encephalopathy hie or death in infants with asphyxia table 7.
Many factors predispose to the onset of neonatal encephalopathy either alone or in a combination including a preconception risk factors, b maternal antepartum intrapartum comorbidities or events, c placental pathology, d hypoxiaischaemia, e perinatal infection, f neonatal stroke or thrombophilia, g metabolic disorders, and h. Our objective was to identify antepartum and intrapartum factors associated. Improvement in antenatal and intrapartum care may be helpful in decreasing the frequency. Our objective was to identify antepartum and intrapartum factors associated with the development of neonatal hie. Impact of thrombophilia on the risk of hypoxicischemic. Mri performed in the neonatal period has made a huge contribution to recognition of different patterns of injury. Improvement in antenatal and intrapartum care may be helpful in decreasing the frequency of this problem. Early cranial ultrasound findings among infants with.
The odds ratio for developing severe hypoxic ischemic encephalopathy and or death with severity of different variables. Infants were defined with hypoxicischemic encephalopathy if they developed seizures, jitteriness, high pitched cry, hypo or hypertonia or hyperreflexia during the neonatal period following. Hypoxic ischemic encephalopathy h linkedin slideshare. Therapeutic hypothermia for infants with hypoxic ischemic. The importance of the intrapartum period martinezbiarge, miriam. Dec 11, 2017 hypoxic ischemic encephalopathy hie is the sub cohort of ne that appears to be driven by intrapartum events.
Despite major advances in monitoring technology and knowledge of fetal and neonatal pathologies, perinatal asphyxia or, more appropriately, hypoxicischemic encephalopathy hie. Obstetric emergencies as antecedents to neonatal hypoxic. Neonatal encephalopathy may result from a variety of conditions. To investigate risk factors for neonatal arterial ischemic stroke nais, and compare them with those present in term controls and infants with hypoxicischemic encephalopathy hie. Martinezbiarge m, diezsebastian j, wusthoff cj, mercuri e, cowan fm. Apr 24, 2010 perwin waly, specialist of pediatrics and neonatology, diploma of hospital manegment asu, international board certified lactation consultant at nicu. Antepartum risk factors for moderate to severe neonatal. Whole body cooling for infants with hypoxicischemic encephalopathy. Our aim was to identify antepartum risk factors for neonatal hypoxic ischemic encephalopathy, with a focus on maternal body mass index and height. Intrapartum factors introduction perinatal hypoxicischemic encephalopathy hie is a syndrome of disturbed neurological. Jun 01, 2016 risk factors for neonatal arterial ischemic stroke. Request pdf antepartum and intrapartum factors preceding neonatal hypoxic ischemic encephalopathy objective.
Antepartum risk factors for moderate to severe neonatal hypoxic. Apr 16, 2019 multifactorial etiology in neonatal encephalopathy. Khurshid f, lee ks, mcnamara p, whyte h, mak w 2011 lessons learned during implementation of therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy in a regional transport program in ontario. Antenatal and intrapartum risk factors for hypoxic. Setting mulago national referral hospital, kampala, uganda. Does aetiology of neonatal encephalopathy and hypoxic.
Incidence of hypoxic ischemic encephalopathy and mortality rate in patients with asphyxia defined as need for bag mask ventilation or apgar score 12mmolsl table 6. Hypoxicischemic encephalopathy hie or perinatal asphyxia occurs in per births,1, 2 affects 12 000 infants in the us each year, and accounts for 22% of neonatal deaths worldwide. Mar 25, 2018 placental, inflammatory and genetic factors have all been suggested to have a role in the pathogenesis. Neonatal encephalopathy ne is a leading cause of neonatal mortality and morbidity worldwide affecting more than one million infants around the world each year 1,2.
Neonatal encephalopathy or hypoxicischemic encephalopathy. Intrapartum factors introduction perinatal hypoxic ischemic encephalopathy hie is a syndrome of disturbed neurological function in the early life characterized by clinical and laboratory proof of acute or subacute brain injury 1. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain. A recent executive summary from the american college of obstetricians. Hospital databases were searched using relevant diagnosis codes to identify infants with neonatal encephalopathy. Longterm outcome after neonatal hypoxicischaemic encephalopathy.
Antepartum and intrapartum factors preceding neonatal hypoxicischemic encephalopathy. To investigate risk factors for neonatal arterial ischemic stroke nais, and compare them with those present in term controls and infants with hypoxic ischemic encephalopathy hie. Intrapartum factors were highly associated with birth asphyxia as prolonged 2nd stage first then meconiumstained amniotic fluid and prenatal visits and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy hie. We found that antepartum, intrapartum and postpartum factors are important risks leading to neonatal encephalopathy. Risk factors for hypoxic ischemic encephalopathy in children. Hypoxic ischemic encephalopathy hie, and subsequent morbidity and mortality, is seldom reported in preterm infants. Neonatal encephalopathy ne occurs in 16 live fullterm births and carries a high risk for subsequent neurodevelopmental disabilities. It is very important to remember that hypoxicischemic encephalopathy hie occurs due to oxygen deprivation. A single center, retrospective cohort study was conducted for 25,494 singleton births. Martinezbiarge m, diezsebastian j, wusthoff cj, et al. Hypoxic ischemic encephalopathy, neonatal encephalopathy, intrapartum factors, risk factors background hypoxic ischemic encephalopathy hie is a subset of neonatal encephalopathy ne attributable to intrapartum events leading to acute hypoxiaischemia.
Risk factors for neonatal arterial ischemic stroke. Obstetric emergencies as antecedents to neonatal hypoxic ischemic. Antepartum and intrapartum factors preceding neonatal hypoxicischemic encephalopathy by m martinezbiarge, j diezsebastian, cj wusthoff, eugenio maria mercuri and fm cowan no static. Perinatal hypoxicischemic encephalopathy hie is an important cause of brain injury in the newborn and can result in longterm devastating consequences. Antepartum and intrapartum factors preceding neonatal hypoxicischemic encephalopathy miriam martinezbiarge, jesus diezsebastian, courtney j. Our objective was to identify antepartum and intrapartum factors associated with the. Khurshid f, lee ks, mcnamara p, whyte h, mak w 2011 lessons learned during implementation of therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy in a. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. Newborns exposed to a perinatal insult typically present with neonatal encephalopathy ne, a descriptive term for a clinical constellation of neurological dysfunctions in the term infant. Encephalopathy is an acute intrapartum event sufficient to cause neuronal injury evidenced by. When caused by diffuse hypoxic ischemic brain injury, it has been called hypoxicischemic encephalopathy hie. Antepartum and intrapartum risk factors for neonatal encephalopathy at term. Antepartum and intrapartum factors preceding neonatal hypoxic ischemic encephalopathy by m martinezbiarge, j diezsebastian, cj wusthoff, eugenio maria mercuri and fm cowan no static citation data no static citation data cite.
Criteria used in term infants to support a diagnosis of hie occur. Risk factors associated with the development of perinatal. Antepartum and intrapartum factors preceding neonatal hypoxicischemic encephalopathy article in pediatrics 24 september 20 with 3 reads how we measure reads. Previous studies have examined antepartum and intrapartum events that are associated with neonatal hie 2,3,4,5. Statewide maternity and neonatal clinical network queensland. Neonatal encephalopathy ne affects 24 live births with outcomes ranging from negligible neurological deficits to severe neuromuscular dysfunction, cerebral palsy and death. Antepartum and intrapartum factors preceding neonatal hypoxic. All websites accessed in this article were accessed december 12, 2017. Perinatal hypoxia is a vital cause of longterm neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and or cerebral palsy in the newborn.