A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation - 25/12/13
, Cliona McGarvey, PhD b, Siobhan Mulvany, MSc a, John Kennedy, MD a, Michael P. Geary, MD a, Tom G. Matthews, MD a, b, Mary D. King, FRCPCH a, b, cAbstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : CART, hypoxic ischemic encephalopathy, meconium, oligohydramnios, uterine contraction
Plan
| Funding for this study was provided by Friends of the Rotunda, an official fundraising arm and registered Charity (CHY240) of the Rotunda Hospital. |
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| The authors report no conflict of interest. |
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| Cite this article as: Hayes BC, McGarvey C, Mulvany S, et al. A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation. Am J Obstet Gynecol 2013;209:29.e1-19. |
Vol 209 - N° 1
P. 29.e1-29.e19 - juillet 2013 Retour au numéro
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