Hypoxic ischemic encephalopathy: Do peripartum risk factors account for observed changes in incidence?

Introduction The risk factors of intracranial hemorrhages (ICH) in the context of neonatal hypoxic ischemic encephalopathy (HIE) and related interventions are unclear. Objective This article examines the prevalence and risk factors associated with ICH in neonates with HIE. Study Design This is a retrospective cohort study of neonates with HIE in Southern Alberta. ICH (subdural [SDH], subarachnoid [SAH], intraventricular [IVH], intraparenchymal [IPH]) were diagnosed by magnetic resonance imaging (MRI). Perinatal and neonatal characteristics were examined. Relation of hemorrhages with hypoxic changes on MRI and HIE stages were assessed. Results Number of HIE patients, n = 157; brain MRI was done in 138 infants; median gestation, 40 weeks; and cooled = 103 (66%). Prevalence of SDH, IPH, IVH, and SAH were 47, 22, 11, and 10 (34.1%, 15.9%, 7.8%, 7.2%), respectively. There was no significant increase in hemorrhage with mode of delivery, seizures, hypo/hypercarbia, severe thrombocytopenia, or deranged coagulation. All hemorrhages increased with higher HIE stage, regardless of the HIE severity in MRI. Adjusting for HIE staging, cooling, and gestation, IPH was observed more in infants who received inotropes (odds ratio [OR], 3.32; 95% confidence interval [CI], 1.20, 9.20). Conclusion SDH followed by IPH were the most common ICH. Thrombocytopenia and deranged coagulation did not increase risk of hemorrhages in HIE. Our study was not powered to determine the impact of inotrope use on the risk of IPH.

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PERINATAL RISK FACTORS FOR HYPOXIC-ISCHEMIC ENCEPHALOPATHY IN PRETERM INFANTS

Scientific digest of association of obstetricians and gynecologists of Ukraine ◽

10.35278/2664-0767.2(42).2018.173371 ◽

2018 ◽

Vol 0 (2(42)) ◽

pp. 126-131

Author(s):

С. П. ПОСОХОВА ◽

О. Ю. КУЧЕРЕНКО ◽

Д. М. ЩУРКО

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Hypoxic Ischemic Encephalopathy ◽

Perinatal Risk Factors ◽

Perinatal Risk ◽

Ischemic Encephalopathy

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Impact of Thrombophilia on the Risk of Hypoxic–Ischemic Encephalopathy in Term Neonates

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029615607302 ◽

2016 ◽

Vol 23 (3) ◽

pp. 266-273 ◽

Cited By ~ 1

Author(s):

Nafisa H. R. AbdelAziz ◽

Hanan G. AbdelAzeem ◽

Eman M. M. Monazea ◽

Tahra Sherif

Keyword(s):

Risk Factors ◽

Protein C ◽

Significant Risk ◽

Hypoxic Ischemic Encephalopathy ◽

Factor V ◽

Parental Consanguinity ◽

Emergency Cesarean ◽

Significant Difference ◽

Factor V G1691a ◽

Ischemic Encephalopathy

Background: The incidence of neonatal hypoxic–ischemic encephalopathy (HIE) is reportedly high in countries with limited resources. Its pathogenesis is multifactorial. A role for thrombophilia has been described in different patterns of preterm and full-term perinatal brain injury. Aim: This study aims to identify risk factors associated with neonatal HIE and also to determine the contributions of genetic thrombophilia in the development of neonatal HIE. Methods: Sixty-seven neonates with HIE and 67 controls were enrolled in the study. Clinical history and examination were undertaken. Patients and controls were tested for the presence of factor V G1691A and prothrombin G20210A mutations. In addition, protein S, protein C, and antithrombin III levels were assessed. Results: Parental consanguinity and performing emergency cesarean section (CS) were significant risk factors for neonatal HIE (odds ratio [OR] 6.5, 95% confidence interval [CI] 2.6-15.3, P < .001, OR 12.6, 95% CI 2.52-63.3, P = .002, respectively). No significant difference was found regarding maternal age and parity. About 33% of cases and 6% of controls were found to have at least 1 thrombophilic factor ( P < .001). Factor V G1691A mutation significantly increased the risk of neonatal HIE (OR 4.5, 95% CI 1.4-14.5, P = .012), while prothrombin G 20210A mutation and protein C deficiency were not. Conclusion: Parental consanguinity, emergency CS, and factor V mutation may contribute to the higher risk of developing neonatal HIE.

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ФАКТОРИ РИЗИКУ ГІПОКСИЧНО-ІШЕМІЧНОЇ ЕНЦЕФАЛОПАТІЇ НЕДОНОШЕНИХ НОВОНАРОДЖЕНИХ

Science Review ◽

10.31435/rsglobal_sr/31032020/6993 ◽

2020 ◽

pp. 7-10

Author(s):

Svitlana Posokhova ◽

Olena Kucherenko

Keyword(s):

Risk Factors ◽

Placental Abruption ◽

Placenta Previa ◽

Fetal Distress ◽

Hypoxic Ischemic Encephalopathy ◽

Fetal Growth Retardation ◽

Premature Newborns ◽

Placental Dysfunction ◽

The Given ◽

Ischemic Encephalopathy

The article presents the results of an assessment of risk factors for the development of hypoxic-ischemic encephalopathy in premature newborns. Perinatal risk factors for hypoxic-ischemic encephalopathy in premature newborns were the factories that lead to the development of placental dysfunction, fetal growth retardation, antenatal fetal distress and premature birth. The most important factor in the development of GIE is gestation (up to 32 weeks gestation), placenta previa with bleeding and premature placental abruption in the given time.

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Profile of Asphyxiated Babies at Tribhuvan University Teaching Hospital

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v29i1.1592 ◽

1970 ◽

Vol 29 (1) ◽

pp. 3-5 ◽

Cited By ~ 3

Author(s):

M Shrestha ◽

L Shrestha ◽

PS Shrestha

Keyword(s):

Risk Factors ◽

Teaching Hospital ◽

University Teaching ◽

Hypoxic Ischemic Encephalopathy ◽

Close Monitoring ◽

Maternal Risk Factors ◽

Maternal Risk ◽

One Year ◽

Vertex Presentation ◽

Ischemic Encephalopathy

Objective: To assess risk factors and outcome in the early neonatal period of babies who were asphyxiated at birth. Methodology: This was a retrospective study conducted at Tribhuvan University Teaching Hospital (TUTH) over a period of one year from 15th Feb 2007 to 14th Feb 2008. All the term babies who had Apgar score of less than < 6 at 1 minute of birth were included. Detailed maternal risk factors during pregnancy and labor were analyzed. The newborn babies who required admission in neonatal unit were again analyzed for development of hypoxic ischemic encephalopathy (HIE) and their outcome. Results: During the study period, out of 3594 term babies, 327 babies (9%) were asphyxiated. Of the total asphyxiated babies, 85% and 15% had moderate and severe asphyxia, respectively, at 1 minute of birth. Out of these asphyxiated babies, 51% and 7% had intrapartum and maternal risk factors, respectively. Intrapartum risk factors like meconium stained liquor, non-vertex presentation, and fetal heart rate abnormalities accounted for 4 fold risk of asphyxia. Of these babies, 26% required admission in nursery and 29% developed hypoxic ischemic encephalopathy. Among the admitted babies 6% expired, 2% left against medical advice and rest were discharged. Conclusion: Early identification and close monitoring of high risk mothers studies with maintaining partograph during labor will help to reduce neonatal asphyxia. Key words: Asphyxiated babies doi:10.3126/jnps.v29i1.1592 J. Nepal Paediatr. Soc. Vol.29(1) p.3-5

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