Analysis of the risk of brain damage in asphyxiated infants

The objectives of this study were to analyze the influence of maternal, perinatal and neonatal factors on the neurological sequelae occurring in asphyxiated infants. The clinical records of 79 infants, 35 weeks of gestation or more, treated in the neonatal intensive care unit in whom the principal diagnosis was asphyxia, and who had no major malformation and who survived for more than 24 hours, were analyzed. Analysis of variance was used to compare neurological outcome classified as 1) normal development or mild neurological sequelae, 2) moderate to severe neurological sequelae, and 3) withdrawal of treatment because of signs and symptoms of severe brain damage. The group in whom treatment was withdrawn had lower mean arterial blood pressure on admission, blood glucose and plasma sodium levels than those in the moderate to severe handicap group. The combined group of brain damaged infants, (2 + 3), had lower Apgar scores at five minutes, umbilical cord arterial blood Standardized Base Excess (SBE), lower urinary output, and higher incidence of seizures and higher plasma potassium level than the group with normal development or those with mild handicap. Stepwise multiple logistic regression confirmed these.