DEFINITION OF BIRTH ASPHYXIA AND INCIDENCE OF NEUROLOGICAL AND SYSTEMIC COMPLICATIONS IN THE FULL-TERM NEWBORN

Patients and methods. - In a prospective multicentric study, 152 of 10 ,065 live term births had birth asphyxia defined by the association of three indicators (fetal distress, depression at birth and metabolic a cidosis). Results. - The incidence of birth asphyxia was 1.5% of live term births when birth asphyxia was defined by the presence of at leas t two indicators, and 1% of live term births when birth asphyxia was d efined by the association of metabolic acidosis and another indicator. Neurological complications were observed in 66 cases (43%). The incid ence of post-asphyxial encephalopathy (PAE) was 5.9 parts per thousand of live term births (mild PAE: 3 parts per thousand; moderate PAE: 2. 7 parts per thousand; severe PAE: 0.2 parts per thousand). Systemic co mplications were observed in 87 patients (57%). Renal injury and coagu lopathy were associated with moderate or severe PAE. Respiratory compl ications (34%), infections (17%) and gastro-intestinal intolerance (15 %) often complicated the course. Severe complications were never seen in the absence of significant metabolic acidosis at 30 minutes of life . Conclusion. - Our study has many implications concerning the diagnos is of birth asphyxia and its complications. A terminology based on cli nical observation and arterial pH evaluation is proposed in order to c larify the situation. (C) 1998 Elsevier, Paris.