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Mortality and Morbidity After Intrapartum Asphyxia in the preterm Fetus

From the Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada

Abstract

This matched cohort study examined the significance of intrapartum fetal asphyxia determined biochemically in the preterm newborn in regard to outcome during the first year. Thirty preterm newborns with metabolic acidosis at delivery were compared with 60 preterm newborns, matched for birth weight, with normal blood gas measures. Deaths during the first year were reviewed. Assessment of the surviving children at 1 year corrected age included neurologic examination, Bayley scales, and Uzgiris and Hunt scale to define motor and cognitive development. Seven asphyxiated infants (23%) died during the first year compared with two nonasphyxiated infants (3%), a statistically significant difference (P<.006). Among the surviving children, the incidence of minor motor and/or cognitive deficits was the same in the two groups. The incidence of major motor and/or cognitive deficits in the group with asphyxia (eight of 30) was significantly greater than in the control group (eight of 60) (P<.03). These results indicate that intrapartum fetal asphyxia in the preterm newborn is a contributing factor to the mortality and morbidity observed in these children.

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