Nuerodevelopmental outcome in perinatal asyphxia

Ashaq H Thoker, Mushtaq Sheikh, Parvez A Thoker, Mukhtar Thoker


Perinatal asphyxia is an important cause of neonatal morbidity and mortality. It might lead to neurologic handicaps in children. To find out the incidence of hypoxic ischemic encephalopathy (HIE) in hospital delivered patients, we studied the correlation between Apgar score HIE stage and neurodevelopmental outcome at one year of age. In this prospective study 93 asphyxiated babies admitted to the neonatal intensive care unit (NICU) during the period of Oct 2012 to Nov 2013 were followed for a period of 1 year. The male to female ratio in HIE was 1.16:1. The incidence of HIE in hospital delivered patients (at Trust Hospital) was 2.2%. Death rate in the NICU was 8.4%. HIE was accounting for 22.4% of total NICU deaths. Head circumference at 1 year was significantly low in HIE patients (especially in HIE III). Seizures were present more frequently in patients with HIE II and HIE III than in HIE I patients. Neurodevelopmental delay was present in 31.2% of patients at the end of 1 year in HIE patients. More number of HIE III patients had developmental delay as compared to HIE I and HIE II. Low Apgar score at 5 minutes and low admission pH were predictors of poor neurodevelopmental outcome. Apgar score at 1 minute was poorly related to neurodevelopmental outcome. It was concluded that the birth asphyxia still remains a major cause of morbidity and mortality during neonatal period.



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