title: A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy.
abstract: The object of this review was to determine the incidence, morbidity, and mortality of an umbilical arterial pH < 7.0; the incidence of hypoxic-ischemic encephalopathy; and the proportion of cerebral palsy associated with intrapartum hypoxia-ischemia in nonanomalous term infants. A systematic review of the English language literature on the association between intrapartum hypoxia-ischemia and neonatal encephalopathy was conducted by using Pubmed and Embase. For nonanomalous term infants, the incidence of an umbilical arterial pH < 7.0 at birth is 3.7 of 1000, of which 51 of 297 (17.2%) survived with neonatal neurologic morbidity, 45 of 276 (16.3%) had seizures, and 24 of 407 (5.9%) died during the neonatal period. The incidence of neonatal neurologic morbidity and mortality for term infants born with cord pH < 7.0 was 23.1%. The incidence of hypoxic-ischemic encephalopathy is 2.5 of 1000 live births. The proportion of cerebral palsy associated with intrapartum hypoxia-ischemia is 14.5%. The vast majority of cases of cerebral palsy in nonanomalous term infants are not associated with intrapartum hypoxia-ischemia.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Gynecology-Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Ernest M
authors.initials: EM
authors.lastname: Graham
authors.forename: Kristy A
authors.initials: KA
authors.lastname: Ruis
authors.forename: Adam L
authors.initials: AL
authors.lastname: Hartman
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Northington
authors.forename: Harold E
authors.initials: HE
authors.lastname: Fox
mesh_terms: D015415:Biomarkers / Q000097:blood; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005312:Fetal Blood; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000175:diagnosis*; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D018570:Risk Assessment; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D047929:Term Birth
chemical_list: D015415:Biomarkers