Hayes BC, McGarvey C, Mulvany S, Kennedy J, Geary MP, Matthews TG, King MD. A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation.
Am J Obstet Gynecol 2013;
209:29.e1-29.e19. [PMID:
23524176 DOI:
10.1016/j.ajog.2013.03.023]
[Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/27/2013] [Accepted: 03/16/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE
The purpose of this study was to determine risk factors that are associated with hypoxic ischemic encephalopathy (HIE).
STUDY DESIGN
This was a case-control study that included newborn infants with HIE who were admitted to the hospital between January 2001 and December 2008. Two control newborn infants were chosen for each case. Logistic regression and classification and regression tree (CART) analysis that compared control infants and cases with grade 1 HIE and control infants and cases with grades 2 and 3 HIE was performed.
RESULTS
Two hundred thirty-seven cases (newborn infants with grade 1 encephalopathy, 155; newborn infants with grade 2 encephalopathy, 61; newborn infants with grade 3 encephalopathy, 21) and 489 control infants were included. Variables that were associated independently with HIE included higher grade meconium, growth restriction, large head circumference, oligohydramnios, male sex, fetal bradycardia, maternal pyrexia and increased uterine contractility. CART analysis ranked high-grade meconium, oligohydramnios, and the presence of obstetric complications as the most discriminating variables and defined distinct risk groups with HIE rates that ranged from 0-86%.
CONCLUSION
CART analysis provides information to help identify the time at which intervention in labor may be of benefit.
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