BIRTH ASPHYXIA - INCIDENCE, CLINICAL COURSE AND OUTCOME IN A SWEDISH POPULATION

A total of 42 203 live infants were born in Goteborg in 1985-1991, and 292 term infants had Apgar scores < 7 at 5 min. Infants with congenit al malformations, infections and opioid-induced respiratory depression were excluded and thus 227 infants were included in the birth asphyxi a group, which formed the basis of this retrospective study. Clinical signs of mild, moderate or severe hypoxic-ischemic encephalopathy (HIE ) were present in 65 infants, and in another 10 infants, sedated and o n controlled ventilation, HIE was assumed but grading was not possible . The incidences of Apgar scores < 7 at 5 min, birth asphyxia and birt h asphyxia with HIE were 6.9, 5.4 and 1.8 per 1000 live born infants: 95% of infants resuscitated with bag and mask ventilation only, did we ll, compared with 1 of 11 in whom resuscitation included adrenaline. S eizures occurred in 27 of 227 infants, beginning in 18 infants within 12 h of birth. Small-for-gestational-age (SGA) infants were overrepres ented in the birth asphyxia group but not in the birth asphyxia-HIE gr oup. All infants with severe HIE died or developed neurological damage . Half of the infants with moderate, and all of the infants with mild, HIE were reported to be normal at 18 months of age. A total of 0.3 pe r 1000 live born infants died and 0.2 per 1000 developed a neurologica l disability related to birth asphyxia. The disabilities were dyskinet ic (4), tetraplegic (2), spastic diplegic (2), cerebral palsy and mild neuromotor dysfunction (1). The relatively low incidences of birth as phyxia and HIE were probably due to effective antenatal care.