Evaluation of risk factors for neonatal hypoxic ischemic encephalopathy

Yıl 2022, Cilt: 27 Sayı: 1, 32 - 38, 29.01.2022

Nuran Üstün

https://doi.org/10.21673/anadoluklin.951203

Cited By: 1

Öz

Aim: Hypoxic ischemic encephalopathy (HIE) is a serious condition in neonates and is associated with neuromuscular dysfunction and death. In this study, we aimed to investigate potential risk factors for neonatal HIE.

Methods: A retrospective case–control study was conducted on infants admitted to our neonatal intensive care unit between 2015 and 2020. Infants born at ≥36 weeks of gestation and diagnosed with HIE were included in the case group. For each case, 4 gestational agematched infants without HIE were selected and included in the control group. The groups were compared in terms of maternal demographic characteristics, pregnancy characteristics, and birth-related factors.

Results: The study included 75 infants with HIE and 300 controls. Nulliparity, history of antenatal care, medical complications during pregnancy, prolonged difficult birth, abnormal fetal heart rate, mode of delivery, and acute birth complications were found to be significantly associated with HIE in univariate analysis. In multivariate logistic analysis, the lack of antenatal care, abnormal fetal heart rate (FHR), and acute birth complication were the strongest factors associated with neonatal HIE.

Conclusion: Our findings demonstrated that the lack of antenatal care, abnormal FHR, and acute birth complications were risk factors for the development of HIE. Ensuring that pregnant women receive adequate antenatal care and applying necessary obstetric measures may help to reduce the HIE incidence.

Anahtar Kelimeler

risk factors, hypoxic ischemic encephalopathy, newborn

Neonatal hipoksik iskemik ensefalopati risk faktörlerinin değerlendirilmesi

Öz

Amaç: Hipoksik iskemik ensefalopati (HİE) yenidoğanlarda ciddi bir problem olup nöromüsküler disfonksiyon ve ölümle ilişkilidir. Bu çalışmada neonatal HİE için potansiyel risk faktörlerini araştırmak amaçlanmıştır.

Yöntem: 2015–2020 yıllarında yenidoğan yoğun bakım ünitemizde yatan bebekler üzerinde retrospektif bir vaka–kontrol çalışması gerçekleştirildi. Vaka grubu ≥36 gebelik haftasında doğan ve HİE tanısı alan bebeklerden oluşturuldu. Her vaka için, HİE’si olmayan, gestasyonel yaş bakımından eşlenik 4 bebek seçildi ve kontrol grubuna dahil edildi. Gruplar maternal demografik özellikler, gebelik özellikleri ve doğumla ilgili faktörler bakımından karşılaştırıldı.

Bulgular: Çalışma 75 HİE’li bebek ve 300 kontrol içerdi. Tek değişkenli analizde nulliparite, antenatal bakım geçmişi, gebelik sırasında tıbbi komplikasyon, uzun süreli zor doğum, anormal fetal kalp hızı, doğum şekli, ve akut doğum komplikasyonları HİE ile anlamlı olarak ilişkili bulundu. Çok değişkenli lojistik analizde antenatal bakım eksikliği, anormal fetal kalp hızı (FKH) ve akut doğum komplikasyonu neonatal HİE ile ilişkili en güçlü faktörler idi.

Sonuç: Bulgularımız antenatal bakım eksikliği, anormal FKH ve akut doğum komplikasyonlarının HİE gelişimi için risk faktörü olduğunu göstermiştir. Gebelerin yeterli antenatal bakım almalarını sağlamak ve gerekli obstetrik önlemleri uygulamak HİE insidansını azaltmaya yardımcı olabilir.

Anahtar Kelimeler

hipoksik iskemik ensefalopati, risk faktörleri, yenidoğan

Kaynakça

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