Intrauterine asphyxia and long-term outcome in preterm fetuses

The long-term outcome of 108 infants born before the 33rd week of gestation was evaluated and correlated to a fetal heart tracing from the last 24 hours before delivery. Infants with signs of asphyxia (N = 30) were born at the same gestational age as those without (N = 78), but had a significantly lower birth weight (P less than .001). Severe intraventricular hemorrhage occurred more often in infants with asphyxia (30%) than in those without (5%) (P less than .05). Fourteen of 30 asphyxia infants (47%) and 11 of 78 nonasphyxia infants (14%) died within the first two years (P less than .005). At two years of age, four (25%) asphyxia and eight (12%) nonasphyxia infants have developmental or neurologic abnormalities (not significant). Of the eight infants with asphyxia born before the 29th week of gestation in the present study, none was normal at two years of age. The authors conclude that signs of asphyxia, as determined from fetal heart rate pattern, were associated with poor fetal outcome, and especially in infants born before the 29th week of gestation. The clinical implications of these findings are discussed.