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Updated: May 13, 2025
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A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy
Published on: May 16, 2015
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Hypoxic-ischemic encephalopathy following intrapartum asphyxia: is it avoidable?
Mikko Tarvonen1, Riina Jernman1, Vedran Stefanovic1
1Department of Obstetrics and Gynecology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.
American Journal of Obstetrics and Gynecology
|May 10, 2025
Summary
Nearly half of term hypoxic-ischemic encephalopathy (HIE) cases with normal admission cardiotocograms were potentially avoidable. Optimal intrapartum care could prevent one-fifth of all HIE cases.
Area of Science:
- Perinatal Medicine
- Neonatology
- Obstetrics
Background:
- The incidence and preventability of term hypoxic-ischemic encephalopathy (HIE) during labor require further investigation.
- Defining "avoidable perinatal brain injury" is crucial for improving neonatal outcomes.
Purpose of the Study:
- To evaluate the impact of intrapartum asphyxia on neonatal HIE.
- To determine the proportion of HIE cases preventable with timely interventions.
Main Methods:
- Retrospective 20-year birth cohort study of term singleton deliveries (N=317,126).
- Analysis of admission and intrapartum cardiotocography (CTG) recordings.
- Assessment of cord blood gases, erythropoietin, S100β, and placental histopathology.
Main Results:
- 314 term HIE cases identified; 44.9% had normal admission CTG.
- 90.1% of HIE with normal admission CTG showed severe acidemia, indicating intrapartum origin.
- Half of intrapartum HIE cases with normal admission CTG were deemed potentially avoidable (22.3% of all HIE cases).
Conclusions:
- 98% of HIE cases with normal admission CTG were linked to intrapartum asphyxia.
- Findings suggest that approximately one-fifth of all HIE cases could be prevented through improved intrapartum care.
- Optimal intrapartum management is critical for reducing HIE incidence.
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