Frequency of perinatal asphyxia and volume of provision of care to newborns in the delivery room

Introduction. Intrauterine hypoxia and asphyxia during childbirth are the leading causes of infant mortality in the structure of certain conditions arising in the perinatal period.Purpose. To study the involvement of negative events for the fetus in the ante- and intranatal periods in the occurrence of perinatal asphyxia in newborns and identify the main modifiable risk factors that will allow formulating preventive strategies in the development of child hypoxia.Materials and methods. A retrospective assessment of the course of the ante- and intranatal period was carried out according to 50 case histories. Nominal data are presented with indication of absolute and relative values. Sets of quantitative indicators are described by the values of the median (Me) and the lower and upper quartiles (Q1–Q3). The χ2 test was used to compare unrelated samples. Differences were considered statistically significant at p < 0.05. Statistical data processing was carried out using the Microsoft Office 2021 software package.Results: In the group of children with moderate and severe asphyxia at birth, the median gestational age was 36 and 33 weeks. The main ante- and intranatal risk factors for asphyxia of newborns were established in the following percentage: fetoplacental insufficiency – 32%; premature rupture of membranes and medical abortions in history, 30% each; first pregnancy, anemia, obesity, hypertension, smoking, maternal age > 35 years, 18% each; isthmic-cervical insufficiency – 16%; history of antenatal death, threatened miscarriage, vaginitis, 14% each; acute respiratory infections during pregnancy, assisted reproductive technologies (IVF), uterine fibroids – 12% each; oligohydramnios – 8%; polyhydramnios – 6%.Conclusion. The structure of factors that can contribute to the development of asphyxia in newborns is diverse. Understanding the involvement of modifiable risk factors determines the need to build a strategy and tactics to reduce their impact on the development of the pathology under consideration.

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Risk factors for birth asphyxia

Taranushenko

Parshin

Vaganov

et al. 2022

Medicinskij sovet

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Perinatal asphyxia of full-term newborns: from pathophysiology to long-term outcomes

Petrova,

Zubkov,

Zakharova

et al. 2023

Nevrol. ž. im. L.O. Badalâna

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The fetal environment and circulatory patterns are very different from that of extrauterine life. The fetus evolved to thrive and grow in a relative hypoxemic environment adapted several mechanisms in response to changes in oxygen concentration in the blood to ensure optimal oxygen delivery to the brain and heart. However according to estimates of the World Health Organization in the world from 4 to 9 million newborns are born annually in a state of perinatal asphyxia. In economically underdeveloped countries, this indicator is higher than in developed countries, but in general, the frequency of perinatal asphyxia remains at a rather high level in the modern world. Perinatal asphyxia or hypoxic-ischemic encephalopathy, in newborns can cause multiple organ dysfunction in the neonatal period, severe diseases in the future, lead to disability and infant mortality. Perinatal asphyxia is characterized by a violation of gas exchange, which can lead to varying degrees of hypoxia, hypercapnia and acidosis, depending on the duration and degree of interruption of air flow, however, obstructed perinatal gas exchange does not have precise biochemical criteria. In addition, the exact mechanisms of pathophysiology of perinatal asphyxia have not been fully studied, as a result of which the “gold standard” of treatment remains an active area of research. The publication reflects modern views on the main stages of the pathogenesis of perinatal asphyxia, shows changes in blood circulation during delivery and the neonatal period, presents current data on emerging disorders in the newborn’s body against the background of hypoxic ischemic encephalopathy.

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Frequency of perinatal asphyxia and volume of provision of care to newborns in the delivery room

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Risk factors for birth asphyxia

Risk factors for birth asphyxia

Perinatal asphyxia of full-term newborns: from pathophysiology to long-term outcomes

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