ABSTRACT
We compared neonatal characteristics and adverse outcome rates of neonates with hypoxic-ischemic
encephalopathy following (1) prolonged partial asphyxia, (2) acute near-total intrapartum
asphyxia, and (3) the two combined. The time course of the insult was determined individually
by two authors from obstetric data and neonatal charts. “Severe adverse outcome” was
defined as death or severe disability detectable by age 2 years. The asphyxial time
course was prolonged partial asphyxia in 167 (45%), acute near-total asphyxia in 96
(26%), combined in 78 (21%), and indeterminate in 34 (8%) patients. Among patients
with known time course and outcomes, 212 (67%) had severe adverse outcome and 103
(33%) were free of severe adverse outcome. Severe adverse outcome rates were 61% for
prolonged partial asphyxia, 67% for acute near-total asphyxia, and 79% for combined
time course asphyxia (p = 0.025). Long-term outcomes differ according to the time course of the insult; infants
with combined time course had the worst outcome.
KEYWORDS
Acute near-total asphyxia - prolonged partial asphyxia - cohort study - long-term
outcome
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Prakesh S ShahM.D.
Department of Paediatrics, Mount Sinai Hospital
775A–600 University Avenue, Toronto, Ontario, Canada M5G 1X5
Email: pshah@mtsinai.on.ca
