Document Detail

The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants.
MedLine Citation:
PMID:  10759262     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine trends in incidence of hypoxic-ischaemic encephalopathy in term infants over a twenty-one year period. DESIGN: A retrospective analysis of medical records of all term infants admitted to a neonatal unit with hypoxic-ischaemic encephalopathy during the years 1992-1996 (period C) and a comparison with data from the years 1976-1980 (period A) and 1984-1988 (period B) from the same unit (previously published). SETTING: A District Health Authority in Central England serving a population of about 450,000. SAMPLE: All term infants admitted with clinical features of hypoxic-ischaemic encephalopathy. MAIN OUTCOME MEASURES: Incidence of three grades of hypoxic-ischaemic encephalopathy, disability and mortality. RESULTS: In each five year period there were similar numbers of births. Over the time-span of this study the stillbirth rate and neonatal mortality rate has consistently fallen. The overall incidence of hypoxic-ischaemic encephalopathy in term infants was significantly lower (P < 0.001; OR 0.42 CI 0.29-0.59) in the present study period (C) compared with the earlier study period B (1.9 vs 4.6 per 1,000 total live births). The fall in moderately and severely affected infants between the present and the first study period was significant (1.2 vs 2.6 per 1,000 total live births, P < 0.001: OR 0.46 CI 0.29-0.72). The number of deaths and the incidence of cerebral palsy in survivors fell progressively over the 21 years spanned by this study. CONCLUSION: This study shows that the incidence of hypoxic-ischaemic encephalopathy and its sequelae in term infants has fallen significantly. The use of cardiotocography and caesarean section rates have risen but the relative contributions of changes in clinical practice are uncertain.
J Smith; L Wells; K Dodd
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  107     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-04-20     Completed Date:  2000-04-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  461-6     Citation Subset:  AIM; IM    
Derbyshire Children's Hospital, Derby, UK.
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MeSH Terms
England / epidemiology
Fetal Death
Hypoxia-Ischemia, Brain / epidemiology*,  mortality
Infant Mortality / trends
Infant, Newborn
Obstetrics / trends
Retrospective Studies

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