title: Might asphyxia cause respiratory inhibition after crying in mature infants?
abstract: BACKGROUND
  To clarify the timing of injury in utero causing respiratory inhibition after crying (RIAC), the relationship between asphyxia and RIAC was investigated in infants whose gestational age was ≥ 36 weeks.
  
  
  METHODS
  RIAC and cranial ultrasound abnormalities were examined for retrospectively in infants treated in the neonatal intensive care unit from April 2004 through March 2009. All included infants were gestational age ≥ 36 weeks and had an Apgar score <4 points at 1 min. The relationship between RIAC and perinatal factors was also examined.
  
  
  RESULTS
  Twenty-six infants were included. Three infants had RIAC, seven infants had poor prognosis, and nine infants had ultrasound abnormalities in the ganglionic eminence (GE). There was a significant relationship between RIAC and ultrasound abnormalities in the GE (P= 0.032). Poor prognosis was significantly associated with low Apgar score at 5 min (P ≤ 0.001), disseminated intravascular coagulation (P= 0.047), hypoxic ischemic encephalopathy (P= 0.028), and brain hypothermia therapy (P= 0.028). There was no significant relationship between RIAC and poor prognosis. All infants had ultrasound abnormalities in the GE on the day of birth.
  
  
  CONCLUSIONS
  Damage occurring in utero prior to 36 weeks gestation might cause increased echogenicity or cyst formation in the GE, potentially disturbing maturation of the respiratory center with the development of RIAC.
authors.affiliation: Department of Neonatal Intensive Care Unit, Nara Prefectural Hospital, Nara, Japan. nicuminowa@yahoo.co.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Minowa
authors.forename: Yuka
authors.initials: Y
authors.lastname: Bando
authors.forename: Hajime
authors.initials: H
authors.lastname: Yasuhara
authors.forename: Ayako
authors.initials: A
authors.lastname: Ohgitani
mesh_terms: D000328:Adult; D001034:Apgar Score; D001049:Apnea / Q000097:blood / Q000000981:diagnostic imaging / Q000196:embryology / Q000209:etiology*; D001238:Asphyxia Neonatorum / Q000150:complications*; D001479:Basal Ganglia / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000196:embryology*; D001784:Blood Gas Analysis; D003448:Crying / Q000502:physiology*; D004453:Echoencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
chemical_list: D010100:Oxygen