Perinatal acidosis and hypoxic-ischemic encephalopathy in preterm infants of 33 to 35 weeks' gestation.
OBJECTIVE
To determine the frequency of hypoxic-ischemic encephalopathy (HIE) in preterm infants of 33 to 35 weeks' gestational age on the basis of physiological screening for perinatal acidosis and neurological assessment of encephalopathy and to correlate neurodevelopmental outcomes with brain magnetic resonance imaging findings.


METHODS
This retrospective cohort study included all inborn infants of 33 to 35 weeks' gestation admitted to the neonatal intensive care unit at Parkland Memorial Hospital with perinatal acidosis from October 2005 to September 2008. Their medical records were reviewed, and pertinent data were recorded.


RESULTS
Of 1305 newborns, 2.5% (n=33) had perinatal acidosis, and 27% (n=9) of these had HIE (2, mild; 4, moderate; 3, severe). Persistence of metabolic acidosis on the first arterial blood gas obtained in the first hour of age was significantly associated with HIE (P<.005). Magnetic resonance imaging results were abnormal in 3 of 4 infants with moderate HIE and in both survivors with severe HIE. Death or disability occurred in no infants with mild or moderate HIE, but in all infants with severe HIE.


CONCLUSIONS
Screening criteria for HIE that use biochemical and neurological assessments as performed in term newborns can be applied to preterm infants of 33 to 35 weeks' gestation.
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA. lina.chalak@utsouthwestern.edu
Lina F
LF
Chalak
Nancy
N
Rollins
Michael C
MC
Morriss
Luc P
LP
Brion
Roy
R
Heyne
Pablo J
PJ
Sánchez
D000138:Acidosis / Q000150:complications / Q000175:diagnosis*; D001921:Brain / Q000473:pathology; D002657:Child Development; D005260:Female; D005865:Gestational Age; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000175:diagnosis*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male