Intrapartum Asphyxia, Neonatal Encephalopathy, Cerebral Palsy, and Obstetric Interventions in the Term and Near-Term Infant

Abstract

Intrapartum asphyxia (IA) as a cause of neonatal encephalopathy (NE) and cerebral palsy (CP) is a concern for obstetric providers due to the significant neonatal sequelae that ensue. CP is a nonprogressive static neuromuscular disorder appearing early after birth that occurs in 2 per 1,000 births. NE is a clinical syndrome of disturbed neurologic function in the first week after birth, and it occurs in 6 per 1,000 live births. Only ∼6% of all term infants diagnosed with CP have a history of NE, and without the development of NE, IA cannot be considered as the sole cause of CP. There are various preconceptional, antepartum, and intrapartum risk factors associated with CP. Obstetric interventions, including various modalities of fetal monitoring and cesarean delivery, have not led to improvement in outcomes or a reduction in the incidence of CP. The goal of this review was to discuss the association of IA with NE and CP in term and near-term infants, with a focus on the diagnosis and risk factors for IA and potential obstetric interventions.