Neonatal Encephalopathy in the Term Newborn

Abstract

Perinatal brain injury is the third leading cause of child mortality globally. Purpose: Evaluation of perinatal risk factors for encephalopathy in neonates in order to prevent deaths and disabilities Method: This is a prospective, case-control study conducted in the Maternity Hospital “K. Gliozheni” during the time period 2012 – 2016. 65 newborns at term ≥37 weeks diagnosed with encephalopathy according to the Thompson classification >5 within 12 hours of birth were compared with a control group, infants without encephalopathy in a 1:1 ratio selected casual and gender-appropriate. Results: Total antepartum risk factors were found in (70.8%) of cases and (18.5%) of controls (p<0.01). Sentinel events were found in 38.5% of cases and in 9.2% of controls. (p<0.01). Acute intrapartum events in total were found in (38.5%) of cases and (9.2%) of controls (p<0.01). 43.1% of babies had a combination of antepartum and intrapartum factors (p<0.01). Significant and independent predictive factors of risk for neonatal encephalopathy resulted: from maternal factors, mother’s age >35 years (p=0.03). Of the intrapartum factors: pregnancy with twins (p<0.01), hypertension/preeclampsia (p<0.01), non-reactive FHR before delivery (p<0.01). MEDICUS No. 6, ISSUE 2/ 2022 103 From intrapartum factors: breech birth (p=0.01), emergency cesarean section (p=0.01), meconial amniotic fluid (p=0.02), prolonged birth (p=0.01). Conclusion: Knowledge of perinatal risk factors associated with neonatal encephalopathy is essential for developing interventions to prevent neonatal death and disability.