Perinatal variables in the children with neonatal encephalopathy
| Moderate | Severe | |
|---|---|---|
| Maternal and or neonatal records were only available for 63/65 children; several data points were not recorded in the notes, hence proportions are shown of cases where the information (positive or negative) was recorded. Cerebral imaging: 54 children had ultrasound scans described in the clinical notes, 43 were “normal”, eight reported showing changes of “cerebral oedema”, one parietal infarct, and two intracerebral haemorrhage. Seven children had follow up computed tomography scans (two “ischaemic changes”; one “frontal intracerebral haemorrhage”; one “infarct”; three “normal”), and two children had magnetic resonance imaging scans (one “right hemiatrophy”; one changes of “hypoxic ischaemic encephalopathy”). In 10/45 children, investigations were undertaken for other aetiologies (10 had urine or blood metabolic screening test, nine had an infection screen, and six karyotypes were evaluated: none showed significant abnormality). | ||
| *Medium (range). | ||
| CTG, cardiotocogram; NICU, neonatal intensive care unit. | ||
| Obstetric information | ||
| Mother primigravida | 75% (24/32) | 68% (21/31) |
| Maternal hypertension | 13% (4/32) | 13% (4/30) |
| Maternal diabetes | − (0/32) | 7% (2/30) |
| Fetal growth restriction | 3% (1/32) | − (0/30) |
| No labour | 3% (1/32) | 13% (4/30) |
| CTG abnormal | 75% (16/20) | 92% (23/25) |
| Emergency caesarean section | 48% (15/31) | 48% (15/31) |
| For fetal distress | 100% (15/15) | 93% (14/15) |
| Spontaneous vertex delivery | 35% (11/31) | 35% (11/31) |
| Condition at delivery | ||
| Heart rate <100/min at 1 min | 17% (5/29) | 19% (5/27) |
| Intubated in delivery room | 50% (16/32) | 80% (24/30) |
| Chest compressions | 12% (3/25) | 31% (8/26) |
| Adrenaline (epinephrine) given (any route) | 8% (2/25) | 30% (8/27) |
| Bicarbonate given | 4% (1/24) | 38% (11/29) |
| Apgar score at 1 min <7 | 81% (25/31) | 97% (29/30) |
| Number with score ⩽3 (no = 0) | 15 (2) | 23 (5) |
| Apgar score at 5 min <7 | 52% (15/29) | 63% (19/30) |
| Number with score ⩽3 (no = 0) | 5 (2) | 9 (2) |
| Apgar score at 10 min <7 (of those recorded) | 5/19 | 10/16 |
| Spontaneous respirations established by 10 min of age | 65% (13/20) | 39% (7/18) |
| Not ventilated in NICU | 90% (18/20) | 27% (6/22) |
| Indication for ventilation | ||
| Apnoea | 11/16 | 16/21 |
| Meconium aspiration | 2/16 | 4/21 |
| Supplemental oxygen given | 43% (9/21) | 83% (19/23) |
| Duration of oxygen therapy (days)* | 1 (1–4) | 3.5 (1–22) |
| Aspartate transaminase >100 units/l | 50% (6/12) | 43% (6/14) |
| Creatinine >100 mmol/l | 44% (12/27) | 68% (17/25) |
| “Oliguria” recorded | 29% (7/24) | 25% (6/24) |
| Inotropic support given | 5% (1/19) | 44% (7/16) |
| Volume bolus given | 24% (5/21) | 63% (12/19) |
| Sucking feeds established (days)* | 4.5 (1–22) | 9 (1–37) |
| Age neurology recorded as normal (days)* | 4 (2–10) | 5 (3–15) |
| Age fits ceased (days)* | 2 (1–7) | 4 (2–15) |
| Age anticonvulsants discontinued (days)* | 5 (1–21) | 10 (2–90) |