Neonatal asphyxia: A study of 210 cases

Abstract

Objectives: Perinatal asphyxia remains an important cause of neonatal morbidity and mortality. The aim of this study was to investigate antenatal, natal, and postnatal risk factors of neonatal asphyxia, relationship with known risk factors and stage of Sarnat and Sarnat scores, the effect of risk factors on hospital discharge and survival for neonates with perinatal asphyxia. Materials and methods: In this study, we retrospectively analyzed the hospital records of 210 patients diagnosed as perinatal asphyxia. The patients' demographic characteristics, antepartum, intrapartum, and postpartum risk factors and Sarnat and Sarnat clinical staging criteria of newborns were analyzed. Results: The risk factors for asphyxia were detected antepartum period in 67.7% of newborns, intrapartum in 91% and potpartum in of 29.5% of neonates. When cases were examined according to the studied years, perinatal asphyxia ratio was the most frequent in 2007 as 28.1%. With a decline over the years, frequency dropped to %21 in 2010. The number of patients with stage 3 and mortality rate were significantly decreased over the years (p

Keywords

• Asphyxia, newborn, risk factors, prognosis

Neonatal asfiksi: 210 vakalık çalışma

Öz

Amaç: Perinatal asfiksi, yenidoğan döneminin önemli mortalite ve morbidite nedenlerinden biridir. Bu çalışmanın amacı yenidoğan asfiksisi için antenatal, natal ve postnatal risk faktörlerini araştırmak, perinatal asfiksili yenidoğanlarda bilinen risk faktörleri ile Sarnat ve Sarnat skorları ilişkisini ve risk faktörlerinin hastanede kalış süresi ve sağkalım ile ilişkisini belirlemektir. Gereç ve yöntem: Bu çalışmada perinatal asfiksi tanısı alan 210 vakanın dosya kayıtları geriye dönük olarak incelendi. Hastaların demografik özellikleri, risk faktörleri ve Sarnat and Sarnat klinik evreleme özellikleri analiz edildi. Bulgular: Hastaların %67,7\'sinde antepartum, %91\'inde intrapartum ve %29,5‘inde postpartum risk faktörü bulunmaktaydı. Yıllara göre incelendiğinde perinatal asfiksili olgu %28,1 oranında en fazla 2007 yılında görülürken yıllar içinde bir düşüş ile birlikte %21 oranında 2010 yılında tanı almıştı ve evre 3 olgu sayısı ve mortalite oranı anlamlı şekilde azalmıştı (p

Anahtar Kelimeler

• Asfiksi, yenidoğan, risk faktörü, prognoz

Kaynakça

1. Can G, Neyzi O, Ertuğrul T. Neonatal Asphyxia. Pediatri 1st Edition Chapter 2002; 353-6.
2. Dilenge ME, Majnemer A, Shevell MI. Long-term developmen- tal outcome of asphyxiated term neonates. J Child Neurol 2001;16 (11): 781-92.
3. Stoll BJ, Kliefman RM. Nervous system disorders. Nelson Textbook of Pediatrics 17th Edition Chapter 2004; 88: 561- 69.
4. Toet MC, Lemmers PM, van Schelven LJ et al. Cerebral oxy- genation and electrical activity after birth asphyxia: their rela- tion to outcome. Pediatrics. 2006;117(2):333-9.
5. Shankaran S. Neonatal encephalopathy: treatment with hypo- thermia. J Neurotrauma. 2009;26(3):437-43.
6. Wu YW, Backstrand KH, Zhao S et al. Declining diagno- sis of birth asphyxia in California: 1991-2000. Pediatrics 2004;114(6):1584-90.
7. Volpe JJ. Neurology of Newborn. 3th ed. WB Saunders Com- pany, 1995; 11-360.
8. Milsom I, Ladfors L, Thiringer K, et al. Influence of maternal, obstetric and fetal risk factors on the prevalence of birth as- phyxia at term in a Swedish urban population. Acta Obstet Gynecol Scand 2002;81(10):909-17.

9. Buchmann EJ, Pattinson RC. Babies who die from labour- related intrapartum hypoxia: a confidential enquiry in South African public hospitals. Trop Doct 2006;36(1):8-10.
10. Gündoğdu M, Retrospective monitoring of patients diag- nosed with perinatal asphyxia and hypoxic-ischemic en- cephalopathy, Van 2010.
11. Nagdyman N, Grimmer I, Scholz T, et al.Predictive value of brain-specific proteins in serum for neurodevelopmental out- come after birth asphyxia. Pediatr Res. 2003;54(2):270-5.
12. Katar S, Devecioğlu C, Sucaklı İA, et al. Hypoxic ischemic encephalopathy 80 Evaluation of full-term newborn patient. Dicle Med J 2007;34(1): 38-41.
13. Jimmy S, Kemiki AD, Vince JD. Neonatal outcome at Modilon Hospital, Madang: a 5-year review. P N G Med J 2003;46(1- 2):8-15.
14. Aggarwal R, Deorari AK, Paul VK. Post-resuscitation management of asphyxiated neonates. Indian J Pediatr 2001;68(12):1149-53.
15. Gül A, Cömert S, Ağzıkuru T. Retrospective Analysis of the cases of perinatal asphyxia. J Kartal TR 2010;21(2):77-83.
16. Tekgul H, Gauvreau K, Soul J, et al. The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics 2006;117(4):1270-80.
17. Chau V, Farnell K. Neonatal Seizures. Current Management In Child Neurology Fourth Edition 2009; Chapter 88; 599-602
18. Sankar MJ, Agarwal R, Aggarwal R et al. Seizures in the newborn. Indian J Pediatr 2008;75(2):149-55.
19. Paul E, Max P, Maja S. Predicting the outcome of post as- phyxial hypoxic ischemic encefalopathy within 4 hours of birth. J Pediatr 1997;131(4): 613-7.
20. Hull J, Dodd KL. Falling incidence of hypoxic-ischaemic encephalopathy in term infants. Br J Obstet Gynaecol 1992;99(5):386-91.