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The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
08:47

The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia

Published on: November 19, 2008

Outcome after intrapartum hypoxic ischaemia at term

Janet M Rennie1, Cornelia F Hagmann, Nicola J Robertson

  • 1UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Huntley Street, London WC1E 6DH, UK. janet.rennie@uclh.org

Seminars in Fetal & Neonatal Medicine
|September 11, 2007
PubMed

Insights

Perinatal hypoxic-ischaemic injury at term is strongly linked to dyskinetic tetraplegic cerebral palsy (CP). Survivors may face cognitive deficits, but ADHD and autism are not linked to this injury.

Area of Science:

  • Neurology
  • Pediatrics
  • Neonatology

Background:

  • Perinatal hypoxic-ischaemia is a significant cause of childhood disability.
  • Understanding the specific disabilities linked to this condition is crucial for diagnosis and management.

Purpose of the Study:

  • To review the evidence linking perinatal hypoxic-ischaemia at term to various childhood disabilities.
  • To clarify the specific types of cerebral palsy (CP) associated with hypoxic-ischaemic insults.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of evidence strength for causal links between hypoxic-ischaemia and specific disabilities.

Main Results:

  • Strongest evidence links profound hypoxic-ischaemia to dyskinetic tetraplegic cerebral palsy.
  • Hemiplegic CP is often caused by stroke, not term hypoxic-ischaemia.
  • Diplegic CP is associated with prematurity and periventricular leukomalacia; ataxic CP is unlikely due to asphyxia.
  • Survivors of perinatal hypoxic-ischaemia are at risk for cognitive deficits, even without motor disorders.

Conclusions:

  • The specific type of cerebral palsy depends on the nature and timing of the insult.
  • Cognitive deficits are a significant risk following perinatal hypoxic-ischaemia.
  • Attention deficit hyperactivity disorder and autism are not caused by hypoxic-ischaemia.
  • Neuroprotective therapies like cooling may reduce the prevalence of CP.

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