Maternal risk factors for adverse outcome in asphyxiated newborns treated with hypothermia: parity and labor duration matter

Xu, Eric Hongbo; Mandel, Valentine; Huet, Cloe; Rampakakis, Emmanouil; Brown, Richard N.; Wintermark, Pia

doi:10.1080/14767058.2019.1706472

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…11,22,23 The rate of moderate/severe HIE in our study was 1.2 per 1000 births, also comparable with contemporary data from other large cohort studies from Sweden 2 (1.7 per 1000 births), and Canada which report an overall neonatal asphyxia rate of 2.3 per 1000 births, and a rate of 0.9 per 1000 births for moderate/severe HIE respectively. 24 Similar to our study, nulliparity regardless of socioeconomic setting has been reported as a risk factor for HIE 2,3,12,[25][26][27] . However, we did not find any difference in socio-economic disparity between the HIE cohort and controls.…”

Section: Discussionsupporting

confidence: 87%

Perinatal antecedents of moderate and severe neonatal hypoxic ischemic encephalopathy: an Australian birth cohort study

Stoke

Schreiber

Hocking

et al. 2022

Preprint

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Objective: The aim of this study was to investigate key antecedents of moderate and severe neonatal hypoxic ischemic encephalopathy (HIE) in a large contemporary Australian birth cohort. Design: A retrospective cohort study of all births meeting the inclusion criteria between 2016-2020. Setting: The Mater Mothers’ Hospital, Brisbane, Australia. This is a quarternary perinatal center and Australia’s largest maternity hospital. Population: All non-anomalous, singleton liveborn infants, >35+0 weeks gestation. Methods: Univariate and multivariate firth logistic regression were used to account for imbalanced frequency classes. Main outcome measure: Neonatal moderate and severe HIE. Results: Overall, 133/46041 (0.29%) infants were diagnosed with HIE, and 56 (0.12%) were diagnosed with moderate/severe HIE. Nulliparity, type 1 diabetes mellitus and maternal intensive care unit admission were associated with increased odds of moderate/severe HIE. Intrapartum risk factors included emergency cesarean birth, emergency cesarean for non-reassuring fetal status or failure to process, intrapartum hemorrhage, and an intrapartum sentinel event (shoulder dystocia, cord prolapse, uterine rupture, placental abruption). Neonatal risk factors included male sex, birth at late preterm gestation (35+0 – 36+6 weeks), Apgar score <4 at 5 minutes, severe respiratory distress requiring ventilatory support and severe acidosis at birth. Conclusions: This cohort study identified a series of potentially modifiable maternal and obstetric risk factors for HIE. Risk factors for HIE do not appear to have changed significantly despite recent advances in obstetric care. Key words: pregnancy, fetus, fetal distress, intrapartum hypoxia, hypoxic ischemic encephalopathy, cerebral palsy Funding source: The authors acknowledge research support by the Mater Foundation.

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Section: Discussionsupporting

confidence: 87%

Perinatal antecedents of moderate and severe neonatal hypoxic ischemic encephalopathy: an Australian birth cohort study

Stoke

Schreiber

Hocking

et al. 2022

Preprint

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“…According to earlier research, nulliparity may be a risk factor for birth asphyxia and poor newborn outcomes (32,33), though the association was not obvious (aOR 1.138, 95% CI 1.059-1.221) in our study. It is generally agreed that primiparous pregnant women had longer labor than multiparous pregnant women during vaginal birth (34).…”

Section: Discussioncontrasting

confidence: 80%

Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China

et al. 2022

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ObjectiveThis study aimed to identify various perinatal maternal characteristics that contributed to neonatal asphyxia (NA) in term and late-preterm newborns based on the data obtained from a Chinese birth registry cohort and to establish an effective model for predicting a high risk of asphyxia.MethodWe retrospectively reviewed and analyzed the birth database from July 1, 2016, to June 30, 2017, in the main economically developed regions of China. Asphyxia was defined as an Apgar score <7 at 5 min post-delivery with umbilical cord arterial blood pH < 7.2 in the infant born after 34weeks. We compared the perinatal maternal characteristics of the newborns who developed asphyxia (NA group, n = 1,152) and those who did not (no NA group, n = 86,393). Candidate predictors of NA were analyzed using multivariable logistic regression. Subsequently, a prediction model was developed and validated by an independent test group.ResultOf the maternal characteristics, duration of PROM ≥ 48 h, a gestational week at birth <37, prolonged duration of labor, hypertensive disorder, nuchal cord, and birth weight <2,500 or ≥4,000 g, abnormal fetal heart rate, meconium-stained amniotic fluid, and placenta previa were included in the predicting model, which presented a good performance in external validation (c-statistic of 0.731).ConclusionOur model relied heavily on clinical predictors that may be determined before or during birth, and pregnant women at high risk of NA might be recognized earlier in pregnancy and childbirth using this methodology, allowing them to avoid being neglected and delayed. Future studies should be conducted to assess its usefulness.

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“…Furthermore, background maternal information was not accounted for, however it is already well known that a combination of risk factors such as nulliparity, prolonged labor and gestational age >41 may increase risk of HIE. [34][35][36] The recording of maternal heart rate instead of fetal heart rate was present in 2 cases and this may also have introduced an error on group allocation. Finally, due to the sensitivity of these cases and the potential medico-legal implications access to data may have been limited.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Physiological CTG categorization in types of hypoxia compared with MRI and neurodevelopmental outcome in infants with HIE

Pereira

Patel

Zaima

et al. 2022

The Journal of Maternal-Fetal & Neonatal Medicine

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Maternal risk factors for adverse outcome in asphyxiated newborns treated with hypothermia: parity and labor duration matter

Cited by 7 publications

References 29 publications

Perinatal antecedents of moderate and severe neonatal hypoxic ischemic encephalopathy: an Australian birth cohort study

Perinatal antecedents of moderate and severe neonatal hypoxic ischemic encephalopathy: an Australian birth cohort study

Perinatal maternal characteristics predict a high risk of neonatal asphyxia: A multi-center retrospective cohort study in China

Physiological CTG categorization in types of hypoxia compared with MRI and neurodevelopmental outcome in infants with HIE

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