title: Risk factors for development of hypoxic-ischemic encephalopathy in Abha City-southwestern Saudi Arabia.
abstract: Hypoxic ischaemic encephalopathy (HIE) is an important cause of permanent damage to central nervous system, which may result in neonatal death or manifest as cerebral palsy or mental deficiency. A matched-case control study of neonatal encephalopathy was conducted in Abha General Hospital, Abha City, Saudi Arabia to determine some possible risk factors for HIE. A total of 57 term infants with clinical evidence of HIE at birth were recruited over a period of 3 years, and compared with the same number of a control group of normal newborns. The cumulative incidence of HIE was 4.9 per 1000 live births (95% CI: 3.1 to 6.3). Moderate or severe encephalopathy occurred in about 63% of all infants, with seizures in 67% of these. All the 57 (100%) infants with encephalopathy required one or more of resuscitation measures compared with only 8 (14%) of the control. Significant antepartum risk factors for HIE include: primiparity (OR=3.13), nonaccessibility to antenatal care (OR=1.89), and pregnancy-induced hypertension(OR=2.13). Significant possible labour and delivery risk factors include: noncephalic presentation (OR=2.76)), antepartum haemorrhage (OR=4.32), instrumental delivery (OR=7.91), and prolonged second stage of labour (OR=6.67). In conclusion, both antepartum and intrapartum factors are important in the causation of HIE in Abha city. Improvement of both antenatal care and care during delivery is a necessity.
authors.affiliation: Department of Paediatrics, College of Medicine and Health Sciences, King Khalid University, P.O. Box 641, Abha. fariss2000@yahoo.com
authors.forename: M A
authors.initials: MA
authors.lastname: AlShehri
authors.forename: W A
authors.initials: WA
authors.lastname: Eid
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology* / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D011295:Prenatal Care; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia; D016896:Treatment Outcome