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. 2024 Nov 10;16(11):e73407.
doi: 10.7759/cureus.73407. eCollection 2024 Nov.

Risk Factors and Predictors of Outcomes in Hypoxic-Ischemic Encephalopathy in Neonates

Ruhi Shaligram  1 , Balakrushna P Garud  1 , Sudhir Malwade  1 , Shailaja V Mane  1 , Jasleen Dua  1 , Mridu Bahal  1 , Mrinali Thakur  1
Affiliations

Risk Factors and Predictors of Outcomes in Hypoxic-Ischemic Encephalopathy in Neonates

Ruhi Shaligram et al. Cureus. .

Abstract

Background Hypoxic-ischemic encephalopathy (HIE) in neonates results from oxygen deprivation at birth, often leading to long-term neurological issues like cerebral palsy. Early detection is key to improving outcomes, but HIE remains a significant cause of neonatal complications. Here we aim to study the risk factors and predictors of outcome in moderate to severe HIE in inborn Term babies in the neonatal intensive care unit (NICU) Methods This prospective observational study was conducted in the NICU at a tertiary care center between August 2022 and July 2024. Forty term neonates diagnosed with moderate to severe HIE based on clinical and MRI findings were included. The study recorded antepartum, intrapartum, and postnatal risk factors, and neonatal outcomes were followed up. Results In this study of 40 term neonates with HIE, 27 (67.5%) were male, 30 (75%) had a birth weight <2.5 kg, and 27 (67.5%) were delivered by cesarean section. Socioeconomic analysis revealed that 17 (42.5%) were from poor backgrounds. Of the mothers, 12 (30%) were over 30 years old and 19 (47.5%) used medications. Intrapartum factors included oligohydramnios in 13 (32.5%) and pregnancy-induced hypertension in 10 (25%). Postnatally, 28 (70%) required resuscitation, and 32 (80%) had a cord blood pH ≤7.0. MRI patterns showed 18 (45%) with basal ganglia/thalamus involvement and 22 (55%) with watershed lesions. At discharge, 39 (97.5%) were sent home, with 5 (12.5%) needing anti-seizure medications. No significant associations were found between MRI patterns and muscle tone or seizure activity. Conclusion This study highlights the complex interplay of maternal, intrapartum, and neonatal factors in the development of HIE. Identifying early risk factors is crucial for developing preventive and therapeutic strategies to reduce the burden of HIE-associated disabilities.

Keywords: hypoxic-ischemic encephalopathy; intrauterine asphyxia; neurological deficits; perinatal hypoxia; risk factors.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Sub-Committee of Dr. D.Y. Patil Vidyapeeth issued approval IESC/PGS2022/41. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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