Neonatal Organ System Injury in Acute Birth Asphyxia Sufficient to Result in Neonatal Encephalopathy

Neonatal organ dysfunction among newborns at gestational age ⩾ 34 weeks and umbilical arterial pH < 7.00

“…In addition to the Apgar score 4 7 at 5 minutes and umbilical arterial pH 4 6.92, sentinel events and maternal history of seizures were factors that increased the likelihood of morbidity among term patients only (Table III). This retrospective cohort study confirms a report by Hankins et al [12] and the report published by ACOG and AAP [1], that a sentinel event during labor is linked to neonatal morbidity. Our finding is supportive of reports by Adamson et al [25] and Badawi et al [26] that a family history of convulsions or neurological illness was a risk factor for neonatal encephalopathy.…”

“…The corresponding neonatal charts were reviewed to determine the presence of the following: intrapartum stillbirth (fetal heart rate [FHR] present prior to the start of cesarean and newborn with persistent Apgar score of 0), admission to neonatal intensive care unit (NICU), seizure disorder, pulmonary dysfunction (intubation for greater than 24 hours), hepatic dysfunction (an elevation of aspartate transaminase, alanine transaminase or lactic dehydrogenase of 1.5 times the upper control level that subsequently normalized), hematologic injury (platelets below 100,000 in the absence of evidence of infection, or the diagnosis of alloimmune or isoimmune thrombocytopenia) or increase in renal dysfunction (serum creatinine 4 1.0 mg/dl or urine output 5 1 ml/kg/ hour or persistent hematuria, or proteinura), cardiac dysfunction (use of pressor agents beyond 2 hours after birth) or neonatal death [5,12].…”

Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin

“…Kidney injury often follows perinatal asphyxia, as blood is shunted toward vital organs. Previous studies have reported a broad range of incidence of AKI after perinatal asphyxia, with rates as high as 72 % in neonates with severe perinatal asphyxia [16][17][18]. The incidence of AKI in index study is comparable to an earlier study by Gupta et al but lesser than that observed by Aggarwal, Karlowicz, and Karlo et al [19][20][21][22].…”

Nucleated red blood cell and platelet counts in asphyxiated neonates sufficient to result in permanent neurologic impairment

“…Recently, Hankins et al [11] have suggested that hematologic injury, as evidenced by a neonatal NRBC count 26% and/or a neonatal platelet count 100 000 per mm 3 within five days of birth, was fairly common during an acute intrapartum asphyxial event sufficient to result in neonatal encephalopathy. Thus, our purpose was to determine among a heterogeneous group of asphyxiated neonates with the diagnosis of HIE and long-term permanent brain damage [12] whether neonates with acute birth asphyxia satisfied the criteria set forth by Hankins et al [11].…”