[Intrapartum asphyxia: Risk factors and short-term consequences]

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Perinatal Research

Background:

• Intrapartum asphyxia is a rare but severe complication of labor with potential for long-term neurological impairment.
• The Cerebral Palsy Task Force defined criteria for attributing cerebral palsy to intrapartum asphyxia, including metabolic acidemia (pH<7 and base deficit ≥12 mmol/L).

Purpose of the Study:

• To identify risk factors for intrapartum asphyxia in term live births.
• To evaluate the short-term consequences of intrapartum asphyxia in newborns.

Main Methods:

• Retrospective study of births between 2002-2010 in a university hospital, including 29,416 live births.
• Inclusion criteria: Cerebral Palsy Task Force criteria and gestational age ≥34 weeks.
• Evaluated markers: Apgar score, cardiotocography, duration of expulsive efforts, amniotic fluid, delivery mode, pre-existing pathologies, and short-term neonatal outcomes (death, multiorgan failure, neonatal encephalopathy).

Main Results:

• Intrapartum asphyxia was identified in 82 newborns (0.27%).
• Abnormal cardiotocography was present in 97.6% of cases; pre-existing maternal pathology in 22%.
• Neonatal encephalopathy occurred in 20.7% of cases, with higher rates associated with pH<6.9 and Apgar score <4.

Conclusions:

• The study found an intrapartum asphyxia rate of 0.27%, lower than the commonly cited 0.5%.
• Commonly used markers effectively predict the risk of early neonatal encephalopathy.
• Further research is recommended to assess long-term psychomotor development and cerebral palsy occurrence.