Perinatal Events and Outcomes Associated with Hypoxic-Ischemic Encephalopathy in Thailand: A Multicenter, Observational Study
Issued Date
2022-09-01
Resource Type
ISSN
01252208
Scopus ID
2-s2.0-85138606519
Journal Title
Journal of the Medical Association of Thailand
Volume
105
Issue
9
Start Page
826
End Page
832
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.105 No.9 (2022) , 826-832
Suggested Citation
Kitsommart R., Thamwiriyakul N., Asawakitipong R., Taesiri U., Wongsinin T., Paes B. Perinatal Events and Outcomes Associated with Hypoxic-Ischemic Encephalopathy in Thailand: A Multicenter, Observational Study. Journal of the Medical Association of Thailand Vol.105 No.9 (2022) , 826-832. 832. doi:10.35755/jmedassocthai.2022.09.13609 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85552
Title
Perinatal Events and Outcomes Associated with Hypoxic-Ischemic Encephalopathy in Thailand: A Multicenter, Observational Study
Other Contributor(s)
Abstract
Background: Risk factors for perinatal hypoxic-ischemic encephalopathy (HIE) differ across high- and low- or middle-income countries. Recent evidence from a randomized trial of therapeutic hypothermia (TH) suggests that the intervention should not be offered in the aforementioned countries because of higher mortality rates and associated morbidity. Objective: To investigate characteristics of infants of 35 weeks or more gestational age (GA) born with HIE and determine the short-term outcomes of recipients of TH. Materials and Methods: A multicenter, retrospective, chart review was conducted of infants with 5-minute Apgar scores of 5 or less admitted to the four tertiary centers in Thailand between 2013 and 2020. Events associated with perinatal hypoxia and outcomes were extracted. Results: The incidence of perinatal HIE was 0.8 per 1,000 livebirths. Among 225 HIE infants, 46.2% had metabolic acidosis, 58.1% experienced hypoxic events, and 92.8% required advanced resuscitation. Among 123 infants who met TH criteria, 83 (67.5%) were treated. The overall HIE-related mortality rate was 24.9%. TH recipients had a lower mortality rate than untreated infants at 32.5% versus 52.5%, respectively (p=0.03) with a relative risk of 0.62 (95% CI 0.40 to 0.95). The findings were comparable to the reports from high-income countries. Conclusion: To correctly select neonates for TH, increased HIE awareness, mandatory cord blood gas analysis, and country-wide dissemination of eligible criteria are necessary for timely intervention.