Abstracto

Antenatal and perinatal predictors of hypoxic encephalolpathy.

Alaa Jumaah Manji Nasrawi *

Approximately 20-30% of infants with HIE die in the neonatal period, and 33-50% of survivors are left with permanent neurodevelopmental abnormalities (cerebral palsy, mental retardation). Several epidemiologic studies have identified adverse sociodemographic factors, maternal conditions, antenatal and neonatal complications in association with HIE. To determine the antenatal factors and perinatal factors that are associated with increased risk of term neonatal Hypoxic-Ischemic Encephalopathy (HIE) in Al Zahraa teaching hospital. During a period between February and October 2019, a total 104 neonate enrolled in the study according to inclusion criteria. A study group contain 44 patient and control 60 neonate. Multiple demographic, antenatal and perinatal factors have been studied as a predictor or HIE. Regarding demographic characteristics of enrolled population we found rural residency increase the probability of HIE [odd ratio and 95% CI = 1.67 (1.2-2.34)]. In antepartum factors, we found that parity less than five and complication during pregnancy increase the probability of HIE.[odd ratio and 95% CI=3.58 (1.69-6.54) and 4.21 (1.68-0.54) respectively]. In intrapartum factors, we found vaginal delivery and complication during labour associated with higher risk of HIE. [Odd ratio and CI=2 (1.13- 3.54) and 9 (3.6-22.7) respectively].With regard to neonatal factors; low Apgar score. [Odd ratio and CI=for Apgar score at 1 min. 7.33 (3.5-15.4), for Apgar score at 5 min. 2.93 (1.94-4.42) and GA<37wks]. And need for advanced resuscitation were associated with higher risk of HIE [odd ratio and CI=3 (1.28-7)]. We conclude that neonate of pregnant women whose have rural residency and had been subjected to complications during her pregnancy have a higher probability to have HIE. Also a pregnant women who have vaginal delivery and subjected to complication during labor are more prone to get HIE in her baby. Neonates who were delivered in a gestational age less than 37 weeks and required advanced resuscitation measures have a higher probability to get HIE.