Application of criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy to acutely asphyxiated neonates

Abstract

Objective: To estimate whether term neonates with acute intrapartum hypoxic ischemic encephalopathy and permanent brain injury satisfied the criteria for causation of cerebral palsy developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy.

Methods: In this descriptive study, patients in the case group were obtained from a registry of singleton, liveborn, term, neurologically impaired neonates. Entry criteria included a reactive intrapartum fetal heart rate pattern followed by a sudden, rapid, and sustained deterioration of the fetal heart rate that lasted until delivery and an umbilical artery cord pH. All patients in the case group were then assessed to determine if they met the criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy.

Results: Thirty-nine neonates met the entry criteria, and the proportion meeting each essential criterion was as follows: 38 of 39 (97.4%) had umbilical artery pH of less than 7.00 and 30 of 30 (100%) had a base deficit of 12 mmol/L or higher; 33 of 34 (97%) had either moderate or severe encephalopathy; 34 of 36 (94%) had spastic quadriplegia or dyskinetic cerebral palsy or death attributable to brain injury; and 39 of 39 (100%) had no identifiable reason for exclusion.

Conclusion: Fetuses that underwent a sudden and sustained deterioration of the fetal heart rate and that subsequently were found to have cerebral palsy demonstrated characteristics consistent with criteria developed by the Task Force on Neonatal Encephalopathy and Cerebral Palsy for intrapartum asphyxial injury.

Level of evidence: III.