Perinatal morbidity and risk of hypoxic-ischemic encephalopathy associated with intrapartum sentinel events

Am J Obstet Gynecol. 2012 Feb;206(2):148.e1-7. doi: 10.1016/j.ajog.2011.09.031. Epub 2011 Oct 6.

Abstract

Objective: To examine perinatal morbidity and rate of hypoxic-ischemic encephalopathy in infants exposed to intrapartum sentinel events.

Study design: Retrospective cohort study from 2000-2005. Perinatal mortality, perinatal morbidity and rate of hypoxic-ischemic encephalopathy were compared in 3 groups of infants exposed to different risk factors for perinatal asphyxia (sentinel events, nonreassuring fetal status, elective cesarean section).

Results: Five hundred eighty-six infants were studied. Perinatal mortality was 6% in the sentinel event group and 0.3% in the nonreassuring fetal status group (relative risk, 2.4; 95% confidence interval, 1.95-2.94). Perinatal morbidity was 2-6 times more frequent in infants exposed to sentinel events; the incidence of hypoxic-ischemic encephalopathy was 10%, compared with 2.5% in the nonreassuring fetal status group (relative risk, 1.93; 95% confidence interval, 1.49-2.52). No infant in the elective cesarean section group died, had perinatal morbidity, or developed encephalopathy.

Conclusion: Intrapartum sentinel events are associated with a high incidence of perinatal morbidity and hypoxic-ischemic encephalopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abruptio Placentae / mortality*
  • Adult
  • Asphyxia Neonatorum / mortality*
  • Cesarean Section / adverse effects
  • Embolism, Amniotic Fluid / mortality*
  • Female
  • Heart Rate, Fetal
  • Humans
  • Hypoxia-Ischemia, Brain / mortality*
  • Incidence
  • Infant Mortality*
  • Infant, Newborn
  • Male
  • Pregnancy
  • Retrospective Studies
  • Uterine Rupture / mortality*