Evaluation of risk factors for neonatal hypoxic ischemic encephalopathy
Öz
Aim: Hypoxic ischemic encephalopathy (HIE) is a serious condition in neonates and is associated with neuromuscular dysfunction and death. In this study, we aimed to investigate potential risk factors for neonatal HIE.
Methods: A retrospective case–control study was conducted on infants admitted to our neonatal intensive care unit between 2015 and 2020. Infants born at ≥36 weeks of gestation and diagnosed with HIE were included in the case group. For each case, 4 gestational agematched infants without HIE were selected and included in the control group. The groups were compared in terms of maternal demographic characteristics, pregnancy characteristics, and birth-related factors.
Results: The study included 75 infants with HIE and 300 controls. Nulliparity, history of antenatal care, medical complications during pregnancy, prolonged difficult birth, abnormal fetal heart rate, mode of delivery, and acute birth complications were found to be significantly associated with HIE in univariate analysis. In multivariate logistic analysis, the lack of antenatal care, abnormal fetal heart rate (FHR), and acute birth complication were the strongest factors associated with neonatal HIE.
Conclusion: Our findings demonstrated that the lack of antenatal care, abnormal FHR, and acute birth complications were risk factors for the development of HIE. Ensuring that pregnant women receive adequate antenatal care and applying necessary obstetric measures may help to reduce the HIE incidence.
Anahtar Kelimeler
Kaynakça
- Lee AC, Kozuki N, Blencowe H, Vos T, Bahalim A, Darmstadt GL, et al. Intrapartum related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. Pediatr Res. 2013;74:50–72.
- Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu. Türkiye’de yenidoğan yoğun bakım ünitelerinde izlenen hipoksik iskemik ensefalopatili olgular, risk faktörleri, insidans ve kısa dönem prognozları. Türkiye Çocuk Hastalıkları Derg. 2008;51:123–9.
- Cowan F, Rutherford M, Groenendaal F, Eken P, Mercuri E, Bydder GM, et al. Origin and timing of brain lesions in term infants with neonatal encephalopathy. Lancet. 2003;361:736–42.
- Badawi N, Felix JF, Kurinczuk JJ, Dixon G, Watson L, Keogh JM, et al. Cerebral palsy following term newborn encephalopathy: a population-based study. Dev Med Child Neurol. 2005;47:293–8.
- Azzopardi DV, Strohm B, Edwards AD, Dyet L, Halliday HL, Juszczak E, et al. Moderate hypothermia to treat perinatal asphyxia encephalopathy. N Engl J Med. 2009;361:1349–58.
- Martinello K, Hart AR, Yap S, Mitra S, Robertson NJ. Management and investigation of neonatal encephalopathy: 2017. Update Arch Dis Child Fetal Neonatal Ed. 2017;102:F346–58.
- Shankaran S, Natarajan G, Chalak L, Pappas A, McDonald SA, Laptook AR. Hypothermia for neonatal hypoxic-ischemic encephalopathy: NICHD neonatal research network contribution to the field. Semin Perinatol. 2016;40:385–90.
- Martinez-Biarge M, Diez-Sebastian J, Wusthoff CJ, Mercuri E, Cowan FM. Antepartum and intrapartum factors preceding neonatal hypoxic-ischemic encephalopathy. Pediatrics. 2013;132:e952–9.
- Parker SJ, Kuzniewicz M, Niki H, Wu YW. Antenatal and intrapartum risk factors for hypoxic-ischemic encephalopathy in a US birth cohort. J Pediatr. 2018;203:163–9.
- Hayes BC, McGarvey C, Mulvany S, Kennedy J, Geary MP, Matthews TG, et al. A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation. Am J Obstet Gynecol. 2013;209:29.e1–19.