Outcome following asphyxial insult in term neonates
Date
2014-03-20
Authors
Scher, L G
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Abstract
The admission records of all newborns admitted to the Johannesburg
Neonatal Intensive Care Unit over a four year period with a birthweight >2000
grams and who were asphyxiated at birth and required ventilation were
reviewed. Follow-up data were obtained from the Neonatal Follow-up Clinic
files.
Of the 109 newborns who fulfilled entry criteria, 73 (70%) were males, 36
(30%) females. The mean gestational age was 36 weeks (± 2,9), mean
birthweight 2700g (± 555). Apgar score at 1 minute was 1-2 in 33% of the
patients, 3-4 in 33% and 5-6 in the remaining 33%. Outcome was normal in
44 (40%), death occurred in 18 (15%) and neurological deficit was found in 6
(6%). Forty tnree (39%) were lost to follow up.
It was shown that in subjects available for follow-up, seizures and
cardiorespiratory complications of asphyxia (congestive cardiac failure/
tricuspid incompetence/ meconium aspiration syndrome/ persistent fetal
circulation) were significantly associated with death or poor neurological
outcome, whereas asphyxia (even requiring ventilation) without the latter
signs and symptoms was predictive of good recovery.