[Perinatal asphyxia, hypoxic-ischemic encephalopathy and neurological sequelae in full-term newborns: an epidemiological study (1)].
[Perinatal asphyxia, hypoxic-ischemic encephalopathy and neurological sequelae in full-term newborns: an epidemiological study (1)].
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足月新生儿围产期窒息、缺氧缺血性脑病与神经系统后遗症的流行病学研究（1）
DOI：
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发表时间：
1996
期刊：
影响因子：
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通讯作者：
M. Moya
中科院分区：
文献类型：
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作者：
J. González de Dios;M. Moya
介绍
围产期窒息及其神经系统表现（缺氧缺血性脑病）是足月婴儿脑损伤和神经系统后遗症的最重要原因。
目的
本研究的目的是了解足月儿围产期窒息、缺氧缺血性脑病和神经系统后遗症的发生率。
材料和方法
1991年11月至1995年2月在圣胡安大学医院（阿利坎特，西班牙）出生的足月婴儿围产期窒息的前瞻性流行病学研究。围生期窒息分为非重度（1分钟Apgar评分≤ 6分和/或脐动脉pH < 7.20，伴胎心率模式异常和/或羊水粪染，需要立即新生儿复苏）和重度（1分钟Apgar评分≤ 3分和脐动脉pH < 7.10）。缺氧缺血性脑病根据Levene和Sarnat & Sarnat分类法分为轻度、中度和重度。根据Finer和Amiel-Tison的神经系统后遗症分级标准，将12-24个月随访的神经系统后遗症分为轻度、中度和重度。
结果
在研究期间，有3，342名足月活产婴儿。围产期窒息156例（重度窒息31例，非重度窒息125例），发生率为4.66例/100例足月新生儿。156例围生期窒息足月儿中25.6%有神经系统表现：缺氧缺血性脑病40例（轻度30例，中度5例，重度5例）。新生儿缺氧缺血性脑病发生率为1.19/100。对窒息新生儿进行定期评估。10名婴儿失访。115例窒息足月儿随访12-24个月，神经系统后遗症发生率为16.5%。
结论
尽管围产期窒息这一术语被广泛使用，但对窒息的临床定义几乎没有统一的标准，这使得对发病率、治疗和结局的比较非常困难。围产期窒息和缺氧缺血性脑病研究的主要流行病学差异是由于对它们的定义不一致。协商一致是必要的。
INTRODUCTION
Perinatal asphyxia, and its neurologic manifestations (hypoxic-ischemic encephalopathy) is the most important cause of brain injury and neurologic sequelae in full-term infants.
OBJECTIVE
The aim of this study was to know the incidence of perinatal asphyxia, hypoxic-ischemic encephalopathy and neurologic sequelae in our full-term infants.
MATERIAL AND METHOD
Prospective epidemiologic study of perinatal asphyxia in full-term infants born in Universitary Hospital San Juan (Alicante, Spain) between November 1991-February 1995. Perinatal asphxyia was graded as non severe (1-minute Apgar score < or = 6 and/or umbilical artery pH < 7.20, with abnormal fetal heart rate patterns and/or meconiumstained amniotic fluid, and the need for immediate neonatal resuscitation) and severe (1-minute Apgar score < or = 3 and umbilical artery pH < 7.10). Hypoxic-ischemic encephalopathy was graded as mild, moderate and severe based on classification of Levene and Sarnat & Sarnat. Neurologic sequelae in 12-24 months follow-up was graded as mild, moderate and severe based on classification of Finer and Amiel-Tison.
RESULTS
During the study period there were 3.342 full-term, live births. Perinatal asphyxia developed in 156 (31 severe and 125 non-severe), with an incidence of 4.66 cases per 100 full-term newborns. Neurologic manifestations was present in 25.6% of 156 term infants with perinatal asphyxia: 40 cases of hypoxic-ischemic encephalopathy (mild in 30, moderate in 5 and severe in 5). The incidence of hypoxic-ischemic encephalopathy was 1.19 cases per 100 full-term infants. The asphyctic newborns were regularly assessed. Ten infants was lost to follow-up. The incidence of neurologic sequelae, in 115 asphyxiated full-term infants follow-up at least 12-24 months, was 16.5%.
CONCLUSIONS
Despite the widespread use of the term perinatal asphyxia, there is little uniformity on the clinical definition of asphyxia, which makes comparison of incidence, treatment and outcome very difficult. The main epidemiologic differences in the studies of perinatal asphyxia and hypoxic-ischemic encephalopathy are due to little agreement on their definition. A consensus is necessary.