
Risk factors for hypoxic–ischemic encephalopathy in cases of severe acidosis: A case–control study
Author(s) -
Lorain Perrine,
Bower Alexandra,
Gottardi Elsa,
Dommergues Marc,
Foix L’Helias Laurence,
Guellec Isabelle,
Kayem Gilles
Publication year - 2022
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.14326
Subject(s) - medicine , apgar score , odds ratio , umbilical artery , meconium , asphyxia , obstetrics , acidosis , pregnancy , gestational age , case control study , encephalopathy , gestation , umbilical cord , pediatrics , fetus , anesthesia , genetics , anatomy , biology
The aim of the study was to identify the obstetric risk factors for hypoxic–ischemic encephalopathy (HIE) in infants with asphyxia at birth. Material and methods This multicenter case–control study covered the 5‐year period from 2014 through 2018 and included newborns ≥36 weeks of gestation with an umbilical pH at birth ≤7.0. Cases were newborns who developed moderate or severe HIE; they were matched with controls with pH ≤7.0 at birth over the same period without moderate or severe HIE. The factors studied were maternal, gestational, intrapartum, delivery‐related, and neonatal characteristics. A multivariable analysis was performed to study the maternal, obstetric, and neonatal factors independently associated with moderate or severe HIE. Results Our review of the records identified 41 cases and 98 controls. Compared with controls, children with moderate or severe HIE had a lower 5‐min Apgar score, lower umbilical artery pH, and higher cord lactate levels at birth and at 1 h of life. Obstetric factors associated with moderate or severe HIE were the occurrence of an acute event (adjusted odds ratio [aOR] 6.4; 95% confidence interval [CI] 1.8–22.5), maternal fever (aOR 3.5; 95% CI 1.0–11.9), and thick meconium during labor (aOR 2.9; 95% CI 1.0–8.6). Conclusions HIE is associated with a lower 5‐min Apgar score and with the severity of acidosis at birth and at 1 h of life. In newborns with a pH <7.0 at birth, the occurrence of an acute obstetric event, maternal fever, and thick meconium are independent factors associated with moderate or severe HIE.