Changing Pattern of Perinatal Brain Injury in Term Infants in Recent Years
| Autor: | Toshiki Takenouchi, Murray Engel, Jeffrey M. Perlman, Amos Grunebaum, Ericalyn Kasdorf |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Pediatrics
medicine.medical_specialty Neonatal intensive care unit Encephalopathy Developmental Neuroscience Risk Factors Birth Injuries medicine Humans Intraparenchymal hemorrhage Asphyxia Neonatorum business.industry Incidence Infant Newborn Apnea medicine.disease Hypotonia Neurology Brain Injuries Hypoxia-Ischemia Brain Pediatrics Perinatology and Child Health Etiology Neurology (clinical) medicine.symptom business Fetal thrombotic vasculopathy Perinatal Depression |
| Zdroj: | Pediatric Neurology. 46:106-110 |
| ISSN: | 0887-8994 |
| Popis: | Perinatal brain injury in term infants remains a significant clinical problem. Recently a change appears to have occurred in the pattern of such injuries. We sought to characterize the incidence, etiology, clinical manifestations, and outcomes of these injuries. A retrospective chart review identified clinical characteristics of neuroimaging, electroencephalography, and placental pathologic findings. Perinatal depression was defined as hypotonia and the need for respiratory support. From January 2004-December 2009, 29,597 term deliveries occurred. Brain injuries in 33 infants (live term births) included hypoxic-ischemic encephalopathy (n = 8; 0.27/1000), subdural hemorrhage (n = 10; 0.34/1000), intraventricular/intraparenchymal hemorrhage (n = 5; 0.17/1000), and focal cerebral infarctions (n = 4; 0.14/1000). Thirteen of 33 infants (39%) were triaged to a regular nursery. Delayed presentations included apnea (n = 6), desaturation episodes (n = 3), and seizures (n = 4). Twenty of 33 (61%) were admitted directly to the neonatal intensive care unit because of perinatal depression or evolving hypoxic-ischemic encephalopathy. Clinical signs included seizures (n = 12) and apnea (n = 2). Nine of 19 manifested electroencephalographic seizures. Pathology included chorioamnionitis (n = 7) and fetal thrombotic vasculopathy (n = 5). The latter was associated with focal cerebral infarctions in 3/4 cases. Most cases attributable to perinatal brain injury, except for evolving hypoxic-ischemic encephalopathy, are not identified according to any perinatal characteristics until the onset of signs, limiting opportunities for prevention. |
| Databáze: | OpenAIRE |
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