The association of intrapartum asphyxia in the mature fetus with newborn behavior

Article Abstract:

Intrauterine asphyxia is associated with injury to the central nervous system (CNS; brain and spinal cord) of the fetus, resulting in disorders in movement and mental function. However, there appear to be thresholds of the degree and duration of asphyxia, below which no damage may appear. To identify these thresholds requires diagnosis of asphyxia and accurate determination of CNS injury. The relationship between intrauterine asphyxia and newborn behavior in 51 full-term newborns with asphyxia and 51 newborns without asphyxia was examined. Behavior was assessed by the Brazelton neonatal behavioral assessment scale at three days and at two weeks. Asphyxia was confirmed by laboratory tests of infants' blood. Asphyxiated infants could be differentiated from other newborns by behavioral differences at two weeks but not at three days. All behaviors were graded by range of state, the rapidity of build-up, peak, and lability of state changes, and by two motor (movement) functions, pulling to sit and motor maturity. These indexes were significantly different in infants with asphyxia. Among newborns with asphyxia, those with a more severe dysfunction, as measured by blood tests, did not differ significantly from those with moderate asphyxia. Apgar scores, which objectively measure health of infants immediately after birth, were significantly lower in infants with asphyxia at one and five minutes. Those with the lowest Apgar scores also tended to have lower behavioral scores in two categories. The results suggest that brain injury resulting from asphyxia may not be apparent immediately following birth, but may rather be delayed. Further, as effects of asphyxia were somewhat slight as measured by behavioral assessment, the threshold for CNS injury due to asphyxia may be rather high. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infants, Infant development, Asphyxia

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Intrapartum fetal asphyxia: definition, diagnosis, and classification

Article Abstract:

Predictions of long-term complications of children who were exposed to lack of oxygen as fetuses may be helped by short-term symptoms, but long-term studies may be needed. About 2% of newborns are exposed to lack of oxygen, and most of these will only experience mild to moderate complications. The short-term outcome for such infants may be determined by brain or other organ complications. Indications that an infant has experienced lack of oxygen are most evident on the first day after birth. Long-term follow-up of such infants could elucidate predictors of long-term complications.

Apnea neonatorum

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Severe fetal asphyxia associated with neuropathology

Article Abstract:

A single incident of lack of oxygen to a fetus may result in brain damage and death. A 25-year-old pregnant woman was involved in a car accident at 35 weeks of pregnancy. She was not wearing a seat belt, and her abdomen hit the steering wheel. She was delivered of a baby girl two and a half hours after the accident. The baby died 28 hours later. Autopsy revealed brain hemorrhages and injuries probably caused by lack of oxygen between the time of the accident and delivery.

Health aspects, Causes of, Traffic accidents, Fetal death

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