Outcomes of resuscitation and perinatal risk factors of 39 dying full-term neonates suffered from severe asphyxia

Abstract

Objective To investigate the prenatal or intrapartum risk factors, resuscitation and its outcomes among full-term but dying newborns after severe asphyxia (Apgar score was 0~1 at 1 min after birth). Methods Totally, 39 dying full-term newborns, who were admitted to the neonatal intensive care unit of Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University from January, 2003 to June, 2014 were analyzed retrospectively. Information on perinatal influencing factors and outcomes of resuscitation were collected and analyzed with Chi-square test. Results All of the babies were divided into died (n=7, 18%, one refused to further treatment) and survived group [n=32, among which 15 suffered from hypoxic-ischemic encephalopathy(HIE) (seven mild, seven moderate and one severe case)]. Fetal heart beat was undetectable in more babies in the died group than in the survived group [2/7 vs 0%(0/32),χ2=4.695,P=0.028]. There were 19 infants with Apgar score≤5 at 5 min,and seven of them died (7/19). The other 12 survived with HIE occurred in eight cases (four mild, three moderate and one severe case) and the rest four babies did not report any neurological complications. Among the ten infants with Apgar score≤5 at 10 min, seven died or refused to treatment and the other three survived with moderate HIE. Conclusions Most of the dying term babies may have promising outcomes after effective resuscitation, especially for those with Apgar score over 5 at 5 min. However, for those dying term babies with Apgar score remains≤5 at 5 min, management after resuscitation should be strengthened to reduce the occurrence of any sequelae or complications. Key words: Asphyxia neonatorum; Resuscitation; Prognosis; Risk factors; Apgar score