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

Ernest M. Graham, Kristy A. Ruis, Adam L. Hartman, Frances J. Northington, Harold E. Fox

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)587-595
Number of pages9
JournalAmerican journal of obstetrics and gynecology
Volume199
Issue number6
DOIs
StatePublished - Dec 1 2008

Keywords

  • cerebral palsy
  • fetal metabolic acidosis
  • hypoxic-ischemic encephalopathy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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