A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy

Am J Obstet Gynecol. 2008 Dec;199(6):587-95. doi: 10.1016/j.ajog.2008.06.094.

Abstract

The object of this review was to determine the incidence, morbidity, and mortality of an umbilical arterial pH < 7.0; the incidence of hypoxic-ischemic encephalopathy; and the proportion of cerebral palsy associated with intrapartum hypoxia-ischemia in nonanomalous term infants. A systematic review of the English language literature on the association between intrapartum hypoxia-ischemia and neonatal encephalopathy was conducted by using Pubmed and Embase. For nonanomalous term infants, the incidence of an umbilical arterial pH < 7.0 at birth is 3.7 of 1000, of which 51 of 297 (17.2%) survived with neonatal neurologic morbidity, 45 of 276 (16.3%) had seizures, and 24 of 407 (5.9%) died during the neonatal period. The incidence of neonatal neurologic morbidity and mortality for term infants born with cord pH < 7.0 was 23.1%. The incidence of hypoxic-ischemic encephalopathy is 2.5 of 1000 live births. The proportion of cerebral palsy associated with intrapartum hypoxia-ischemia is 14.5%. The vast majority of cases of cerebral palsy in nonanomalous term infants are not associated with intrapartum hypoxia-ischemia.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • Cerebral Palsy / epidemiology*
  • Cerebral Palsy / etiology*
  • Cerebral Palsy / physiopathology
  • Female
  • Fetal Blood*
  • Follow-Up Studies
  • Humans
  • Hydrogen-Ion Concentration
  • Hypoxia-Ischemia, Brain / complications*
  • Hypoxia-Ischemia, Brain / diagnosis*
  • Incidence
  • Infant, Newborn
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Risk Assessment
  • Seizures / epidemiology
  • Seizures / etiology
  • Seizures / physiopathology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Survival Analysis
  • Term Birth

Substances

  • Biomarkers