medigraphic.com
ISSN 1561-3119 (Electronic)

2013, Number 1

<< Back Next >>

Rev Cubana Pediatr 2013; 85 (1)

Epidemiology of neonatal encephalopathy in a tertiary level hospital in Cuba

Robaina CGR, Santiago LAM, Riesgo RSC, Rodríguez DN

Language: Spanish
References: 30
Page: 51-65
PDF size: 145.32 Kb.


ABSTRACT

Introduction: the risk factors related to the onset of neonatal encephalopathy have been poorly treated in the Third World countries. Likewise, the incidence of this disease in most of the Cuban perinatal care centers is unknown.
Objective: to determine the incidence and risk factors of neonatal encephalopathy in a tertiary perinatal care hospital.
Methods: a retrospective analytical study was carried out in 35 neonates suffering neonatal encephalopathy from a cohort of 19 577 neonates born at the provincial gynecological and obstetric hospital in Matanzas in the period of 2005 to 2011. A case-control study was conducted to determine the risk factors, on the basis of a bivariate analysis, with a case-control ration of 1:3.
Results: the incidence of the neonatal encephalopathy was 1.78 per 1 000 livebirths. Neonatal encephalopathy after asphyxia was seen in 48.5% of cases. Maternal hypertension during pregnancy, maternal history of chronic hypertension, rural origin of the mother and the male sex were the antenatal risk factors found. On the other hand, the intranatal risk factors were severe distress at birth, circular tightening around the neck, premature rupture of membranes, clinical chorioamnionitis, placenta previa, unquiet fetal state and meconial amniotic fluid.
Conclusions: the perinatal and some antenatal risk factors are significant in the studied population from an epidemiological viewpoint.


REFERENCES

  1. Fleiss B, Gressens P. Tertiary mechanisms of brain damage: a new hope for treatment of cerebral palsy? Lancet Neurol. 2012;11:556-66.

  2. Kaindl AM, Favrais G, Gressens P. Molecular mechanisms involved in injury to the preterm brain. J Child Neurol. 2009;24:1112-8.

  3. García-Alix A, Quero J. Estado fetal no tranquilizador, asfixia perinatal y encefalopatía neonatal Servicio de Neonatología. Hospital Universitario La Paz. Madrid. España. An Esp Pediatr. 2007;39:381-4.

  4. Leviton A, Nelson KB. Problems with definitions and classifications of newborn encephalopathy. Pediatr Neurol. 1992;8:85-90.

  5. McCann JWJ, Phelan E. Pediatric neurological emergencies. En: Maricek B, Dondelinger RF. Emergency radiology. Berlín: Springer Berlin Heidelberg; 2007. p. 583-99.

  6. Graham EM, Ruis KA, Hartman AL, Northington FJ, Fox HF. A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy. Am J Obstet Gynecol. 2008;199(6):587-95.

  7. Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O'Sullivan F, Burton PR, et al. Antepartum risk factors for newborn encephalopathy: The western Australian case-control study. BMJ. 1998;317:1549-524.

  8. Pierrat V, Haouari N, Liska A, Thomas D, Subtil D, Truffert P. Prevalence, causes, and outcome at 2 years of age of newborn encephalopathy: population based study. Arch Dis Child Fetal Neonatal Ed. 2005;90(3):F257-61.

  9. Cowan F, Rutherford M, Groenendaal F, Eken P, Mercuri E, Bydder GM, et al. Origin and timing of brain lesions in term infants with neonatal encephalopathy. Lancet. 2003;361(9359):736-42.

  10. Korzeniewski SJ, Birbeck G, DeLano MC, Potchen MJ, Paneth N. A systematic review of neuroimaging for cerebral palsy. J Child Neurol. 2008;23:216-27.

  11. Robaina Castellanos GR. Prevalencia y factores de riesgo de parálisis cerebral en Matanzas (años de nacimiento 1996-2002) [Tesis presentada en opción al grado científico de Doctor en Ciencias Médicas]. La Habana; 2010.

  12. Mansito González N. Asfixia grave: incidencia, evolución clínica y pronóstico en el período neonatal [Tesis de Terminación de la Especialidad en Neonatología]. Facultad de Ciencias Médicas de Matanzas; 1998.

  13. Sarnat Hb, Sarnat MS. Neonatal encaphalopathy following fetal distress: a clinical and electroencephalography study. Arch Neurol. 1976;33:696-705.

  14. García-Alix A, Martínez-Biarge M, Diez J, Gayá F, Quero J. Encefalopatía neonatal hipóxico-isquémica: incidencia y prevalencia en la primera década del siglo XXI. An Pediatr (Barc). 2009;71(4):319-26.

  15. Funayama CA, Moura-Ribeiro MA, Gonçalves AL. Encefalopatia hipóxico-isquémica em recém-nascidos a termo. Aspectos da fase aguda e evoluçäo/hypoxic-ischemic encephalopathy in infant newborn. Acute period and outcome. Arq Neuropsiquiatr. 1997;55(4):771-9.

  16. Salvo H, Vascopé X, Hering Araya E, Pennaroly L, Valenzuela B, Santos G. Seguimiento de recién nacidos de término con encefalopatía hipóxica isquémica. Rev Chil Pediatr. 2002;73(4):357-62.

  17. Garbutt A, Trotman H. Outcome of neonates with hypoxic ischaemic encephalopathy admitted to the neonatal unit of the University Hospital of the West Indies. Ann Trop Paediatr. 2009 Dec;29(4):263-9.

  18. Ellis M, Manandhar N, Manandhar DS, de L Costello AM. Risk factors for neonatal encephalopathy in Kathmandu, Nepal, a developing country: unmatched case-control study. BMJ. 2000;320(7244):1229-36.

  19. Flidel-Rimon O, Stuart Shinwell E. Neonatal aspects of the relationship between intrapartum events and cerebral palsy. Clin Perinatol. 2007;34:439-49.

  20. García-Alix A, Martínez-Biarge M, Arnaez J, Valverde E, Quero J. Asfixia intraparto y encefalopatía hipóxico-isquémica. En: Asociación Española de Pediatría. Sociedad Española de Neonatología. 2da. edición [homepage en Internet]. Protocolos Diagnóstico Terapéuticos de la AEP: Neonatología; 2008 [citado 21 de junio de 2012]. Disponible en: http://www.aeped.es/sites/default/files/documentos/26.pdf

  21. Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O'Sullivan F, Burton PR, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ. 1998;317(7172):1554-8.

  22. Dias BR, Piovesana MAS, Montenegro MA, Guerreiro MM. Desenvolvimento neuropsicomotor de lactentes filhos de mães que apresentaram hipertensão arterial na gestação/ Neuropsychomotor development of infants born of mothers with gestational hypertension. Arq Neuropsiquiatr. 2005;63(3A):632-6.

  23. Impey L, Greenwood C, Sheil O, MacQuillan K, Reynolds M, Redman C. The relation between pre-eclampsia at term and neonatal encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2001;85:F170-72.

  24. Willoughby RE Jr, Nelson KB. Chorioamnionitis and brain injury. Clin Perinatol. 2002;29:603-21.

  25. Klinger G, Beyene J, Shah P, Perlman M. Do hyperoxaemia and hypocapnia add to the risk of brain injury after intrapartum asphyxia? Arch Dis Child Fetal Neonatal Ed. 2005;90(1):F49-52.

  26. Robaina Castellanos GR. Asociación entre factores perinatales y neonatales de riesgo y parálisis cerebral. Rev Cubana Pediatr [serie en Internet]. 2010 [citado 20 de junio de 2012];82(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312010000200008&lng=es&nrm=iso&tlng=es

  27. Robaina Castellanos GR, Riesgo Rodríguez SC. Factores de riesgo de parálisis cerebral en niños cubanos nacidos a término. Saludarte. Abril-Julio 2010;8(1):3-19.

  28. Wu YW, Croen LA, Shah SJ, Newman TB, Najjar DV. Cerebral Palsy in a Term Population: Risk Factors and Neuroimaging Findings. Pediatrics. 2006;118(2):690-7.

  29. Dammann O, Leviton A. Inflammatory brain damage in preterm newborns-dry numbers, wet lab, and causal inferences. Early Hum Dev. 2004;79(1):1-15.

  30. Rizzi DA. Causal reasoning and the diagnostic process. Theoretical Medicine. 1994;15:315-33.




2020     |     www.medigraphic.com