Risk factors for hypoxic-ischemic encephalopathy in cases of severe acidosis: A case-control study.

Content Provider	Europe PMC
Author	Lorain, Perrine Bower, Alexandra Gottardi, Elsa Dommergues, Marc Foix L’Helias, Laurence Guellec, Isabelle Kayem, Gilles
Abstract	AbstractIntroductionThe aim of the study was to identify the obstetric risk factors for hypoxic–ischemic encephalopathy (HIE) in infants with asphyxia at birth.Material and methodsThis 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.ResultsOur 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).ConclusionsHIE 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.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9564668&blobtype=pdf
Page Count	8
ISSN	00016349
Journal	Acta Obstetricia et Gynecologica Scandinavica [Acta Obstet Gynecol Scand]
Volume Number	101
DOI	10.1111/aogs.14326
PubMed Central reference number	PMC9564668
Issue Number	4
PubMed reference number	35338480
e-ISSN	16000412
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2022-03-26
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Subject Keyword	acidosis encephalopathy hypoxic–ischemic intrapartum asphyxia umbilical pH
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology