Pediatrics and Pediatric Surgery

Biography

Biography: A. Cristina ROSSI

Abstract

The aim of this study is to review literature about the risk factors of neonatal hypoxic ischemic encephalopathy (HIE). A search in PubMed, MEDLINE, Embase, Clinicaltrials.gov and reference lists from 1999 to 2018 was performed. Key words: neonatal encephalopathy, hypoxic-ischemic encephalopathy, fetal/neonatal brain injury, sentinel event, birth asphyxia, cerebral palsy, neonatal seizure, fetal pH, Apgar score, term delivery, intrapartum/antepartum risk factors. Inclusion criteria: study population composed of neonates who manifested HIE within 28 days from delivery, data reported in proportional rate. Studies were excluded if they did not meet inclusion criteria, included preterm pregnancies, postnatal conditions leading to HIE and/or fetal malformations, focused on a single risk factors, were not in English language. PRISMA guidelines were followed. Inter-studies heterogeneity was assessed and random or fixed models were generated as appropriate. Comparison between neonates with HIE vs. controls was performed by calculating odds ratio and 95% Confidence Interval (OR-95%CI). Differences were significant if 95% CI did not encompass 1. Twelve articles were included. Fetuses with growth restriction (OR: 2.87; 95% CI: 1.77-4.67), non-reassuring cardiotocography (OR: 6.38; 95% CI: 2.56-15.93), emergency cesarean section (OR: 3.69; 95% CI: 2.75-4.96), meconium (OR: 3.76; 95% CI: 2.58-5.46) and chorioamnionitis (OR: 3.46: 95% CI: 2.07-5.79) were at higher risk of developing HIE. Nulliparity, gestational diabetes, hypertension, oligohydramnios, polyhydramnios, male gender, induction of labor, labor augmentation, premature rupture of membrane, and vacuum delivery were not significantly different. Neonatal hypoxic ischemic encephalopathy has multifactorial origin and its cause is often undetermined and not preventable.