J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website http://www.jcgo.org

Original Article

Volume 3, Number 3, September 2014, pages 97-104

Prediction of Perinatal Hypoxic Encephalopathy: Proximal Risk Factors and Short-Term Complications

**Table 1.** Maternal Characteristics of the Women Included in This Study
Variable	Normal group (n = 493)	Asphyxial group (n = 59)	P
Mean ± standard deviation (SD); BMI: body mass index.
Age	28.8 ± 6.26	27.63 ± 5.9	NS
Primigravida	137 (27.8%)	24 (40.7%)	0.024
Parity	2.24 ± 2.0	1.1 ± 1.4	0.02
BMI	28.15 ± 4.9	28.1 ± 6.1	NS

Table 1. Maternal Characteristics of the Women Included in This Study

Variable

Normal group (n = 493)

Asphyxial group (n = 59)

Mean ± standard deviation (SD); BMI: body mass index.

Age

28.8 ± 6.26

27.63 ± 5.9

Primigravida

137 (27.8%)

24 (40.7%)

0.024

Parity

2.24 ± 2.0

1.1 ± 1.4

0.02

BMI

28.15 ± 4.9

28.1 ± 6.1

**Table 2.** Medical and Obstetric Risk Factors
Variable	Normal group (n = 493)	Asphyxial group (n = 59)	P
CS: cesarean section; PROM: prelabor rupture of membranes; FGR: fetal growth restriction; APH: antepartum hemorrhage; PIH: pregnancy-induced hypertension.
DM	33 (6.9%)	3 (5.1%)	NS
PIH	35 (7.1%)	10 (16.9%)	0.01
Other diseases	20 (4.1%)	2 (3.4%)	NS
Total CS	89 (17.9%)	8 (13.6%)	NS
Previous 1 CS	51 (10.3%)	5 (8.5%)	NS
Previous ≥ 2 CS	38 (7.7%)	3 (5.1%)	NS
PROM	87 (17.6%)	10 (16.9%)	NS
Preterm delivery	67 (13.6%)	12 (20.3%)	NS
Post term ≥ 42	21 (4.3%)	-
FGR	14 (2.8%)	4 (6.8%)	0.02
Malpresentation	25 (4.8%)	2 (3.4%)	NS
APH	6 (1.2%)	4 (6.8%)	0.02

Table 2. Medical and Obstetric Risk Factors

Variable

Normal group (n = 493)

Asphyxial group (n = 59)

CS: cesarean section; PROM: prelabor rupture of membranes; FGR: fetal growth restriction; APH: antepartum hemorrhage; PIH: pregnancy-induced hypertension.

33 (6.9%)

3 (5.1%)

PIH

35 (7.1%)

10 (16.9%)

0.01

Other diseases

20 (4.1%)

2 (3.4%)

Total CS

89 (17.9%)

8 (13.6%)

Previous 1 CS

51 (10.3%)

5 (8.5%)

Previous ≥ 2 CS

38 (7.7%)

3 (5.1%)

PROM

87 (17.6%)

10 (16.9%)

Preterm delivery

67 (13.6%)

12 (20.3%)

Post term ≥ 42

21 (4.3%)

FGR

14 (2.8%)

4 (6.8%)

0.02

Malpresentation

25 (4.8%)

2 (3.4%)

APH

6 (1.2%)

4 (6.8%)

0.02

**Table 3.** Labor Outcomes
Variable	Normal group (n = 493)	Asphyxial group (n = 59)	P
G. age: gestational age; Ab. CTG: abnormal cardiotocogram; SVD: spontaneous vaginal delivery; PPH: post-partum hemorrhage; HS: hospital stay.
G. age	38.6 ± 3.1	37.8 ± 4.2	NS
Induction	32 (6.5%)	8 (13.6%)	NS
Augmentation	80 (16.2%)	12 (20.3%)	NS
Meconium	220 (44.6%)	23 (39.0%)	NS
Ab. CTG	57 (11.6%)	18 (30.5%)	0.001
Intrapartum pyrexia	6 (1.2%)	2 (3.4%)	NS
Abruption	4 (0.8%)	3 (5.1%)	0.03
Eclampsia	1 (0.2%)	1 (1.7%)	NS
Labor duration (h)	6.3 ± 3.5	8.70 ± 4.5	0.04
D. second stage (min)	26.0 ± 33.7	48.0 ± 40.7	0.001
SVD	307 (62.3%)	29 (49.2%)	NS
Vacuum	26 (5.3%)	12 (20.3%)	0.001
Total CS	160 (32.5%)	18 (30.5%)	NS
Elective CS	33 (6.7%)	2 (3.4%)	NS
Emergency CS	127 (25.8%)	16 (27.1%)	NS
Fetal Wt.	3,010 ± 707.2	2,723 ± 833.1	NS
Macrosomia	20 (4.1%)	3(5.1%)	NS
HS (days)	2.1 ± 1.4	2.5 ± 2.2	0.001

Table 3. Labor Outcomes

Variable

Normal group (n = 493)

Asphyxial group (n = 59)

G. age: gestational age; Ab. CTG: abnormal cardiotocogram; SVD: spontaneous vaginal delivery; PPH: post-partum hemorrhage; HS: hospital stay.

G. age

38.6 ± 3.1

37.8 ± 4.2

Induction

32 (6.5%)

8 (13.6%)

Augmentation

80 (16.2%)

12 (20.3%)

Meconium

220 (44.6%)

23 (39.0%)

Ab. CTG

57 (11.6%)

18 (30.5%)

0.001

Intrapartum pyrexia

6 (1.2%)

2 (3.4%)

Abruption

4 (0.8%)

3 (5.1%)

0.03

Eclampsia

1 (0.2%)

1 (1.7%)

Labor duration (h)

6.3 ± 3.5

8.70 ± 4.5

0.04

D. second stage (min)

26.0 ± 33.7

48.0 ± 40.7

0.001

SVD

307 (62.3%)

29 (49.2%)

Vacuum

26 (5.3%)

12 (20.3%)

0.001

Total CS

160 (32.5%)

18 (30.5%)

Elective CS

33 (6.7%)

2 (3.4%)

Emergency CS

127 (25.8%)

16 (27.1%)

Fetal Wt.

3,010 ± 707.2

2,723 ± 833.1

Macrosomia

20 (4.1%)

3(5.1%)

HS (days)

2.1 ± 1.4

2.5 ± 2.2

0.001

**Table 4.** Neonatal Complications for Infants Born ≥ 35 Weeks
Variable	Normal group (n = 426)	Asphyxial group (n = 47)	P
IVH: intraventricular hemorrhage; NICU: neonatal intensive care unit; NND: neonatal death.
5-min AS ≤ 5	8 (2%)	4 (8.5%)	0.02
pH ≤ 7	7 (1.6%)	21 (44.6%)	0.001
NICU admission	10 (2.35%)	11 (23.4%)	0.001
Intubation	2 (0.5%)	1 (2.13%)	0.3
Seizures	-	-
IVH	-	-
N. sepsis	1 (0.2%)	4 (8.5%)	0.001
NND	1 (0.2%)	1 (2.13%)	0.2

Table 4. Neonatal Complications for Infants Born ≥ 35 Weeks

Variable

Normal group (n = 426)

Asphyxial group (n = 47)

IVH: intraventricular hemorrhage; NICU: neonatal intensive care unit; NND: neonatal death.

5-min AS ≤ 5

8 (2%)

4 (8.5%)

0.02

pH ≤ 7

7 (1.6%)

21 (44.6%)

0.001

NICU admission

10 (2.35%)

11 (23.4%)

0.001

Intubation

2 (0.5%)

1 (2.13%)

0.3

Seizures

IVH

N. sepsis

1 (0.2%)

4 (8.5%)

0.001

NND

1 (0.2%)

1 (2.13%)

0.2

**Table 5.** Neonatal Complications for Infants Born < 35 Weeks
Variable	Normal group (n = 67)	Asphyxial group (n = 12)	P
IVH: intraventricular hemorrhage; NICU: neonatal intensive care unit; NND: neonatal death.
5-min AS ≤ 5	11 (16.4%)	6 (50%)	0.02
pH ≤ 7	-	3 (25%)
NICU admission	24 (35.8%)	9 (75%)	0.013
Intubation	10 (15%)	8 (66.7%)	0.001
Seizures	2 (3%)	2 (16.7%)	0.1
IVH	5 (7.5%)	3 (25%)	0.1
N. sepsis	4 (6%)	3 (25%)	0.1
NND	1 (1.5%)	4 (33.3%)	0.002

Table 5. Neonatal Complications for Infants Born < 35 Weeks

Variable

Normal group (n = 67)

Asphyxial group (n = 12)

IVH: intraventricular hemorrhage; NICU: neonatal intensive care unit; NND: neonatal death.

5-min AS ≤ 5

11 (16.4%)

6 (50%)

0.02

pH ≤ 7

3 (25%)

NICU admission

24 (35.8%)

9 (75%)

0.013

Intubation

10 (15%)

8 (66.7%)

0.001

Seizures

2 (3%)

2 (16.7%)

0.1

IVH

5 (7.5%)

3 (25%)

0.1

N. sepsis

4 (6%)

3 (25%)

0.1

NND

1 (1.5%)

4 (33.3%)

0.002

**Table 6.** Multinomial Logistic Reggression Analysis (R² Nagelkerke) Model Summary
Dependent variables/predictors	M. disease	Ob. risk factors	Ab. CTG	M. delivery	Labor duration
NICU: neonatal intensive unit; IVH: intraventricular hemorrhage; NDD: neonatal death.
Base deficit (≥ 12 mmol/L)	NS	NS	0.003	NS	0.04
5-min AS	NS	NS	0.001	NS	NS
NICU	NS	0.045	0.001	NS	NS
Intubation	NS	0.001	NS	0.007	NS
Convulsion	NS	NS	NS	0.031	NS
IVH	NS	NS	NS	NS	NS
pH ≤ 7	NS	NS	0.001	NS	0.028
NDD	NS	NS	NS	NS	NS

Table 6. Multinomial Logistic Reggression Analysis (R² Nagelkerke) Model Summary

Dependent variables/predictors

M. disease

Ob. risk factors

Ab. CTG

M. delivery

Labor duration

NICU: neonatal intensive unit; IVH: intraventricular hemorrhage; NDD: neonatal death.

Base deficit (≥ 12 mmol/L)

0.003

0.04

5-min AS

0.001

NICU

0.045

0.001

Intubation

0.001

0.007

Convulsion

0.031

IVH

pH ≤ 7

0.001

0.028

NDD