Background: Perinatal asphyxia comprised 23% of neonatal death. This condition usually affects multiorgan especially central nervous system, resulting to death and disabilities. The incidence of hypoxic ischemic encephalopathy varies considerably by area and is increased in middle-to-low-income countries.
Objective: This study aimed to determine the mortality rate, short-term outcomes and factors which influence on death of HIE infants in Thailand.
Methods: This was a retrospective study. Data was collected from electronic medical records of newborn infants who were diagnosed perinatal HIE with all of the followings: gestational age >35 weeks, birth weight ≥2,000 grams and admitted at the Chiang Mai University Hospital between January 1st, 2005 and December 31st ,2019
Results: This study included 162 patients. 91 males (56.2%) and 73 females (43.8%), mean(SD) gestational age and birth weight were 38.4 (1.5) weeks and 3,094 (359.41) grams, respectively. Overall mortality rate was 16 %, which composed of 5%, 5.4% and 54.1% in mild, moderate and severe HIE cases, respectively. At discharge, 16.2% of infants required tube-feeding, 10.2% needed oxygen therapy, 55.1% continued antiepileptic drug(s), and 11.1% had abnormal hearing screening. Mean (SD) duration of intubation and length of stay were 10.7 (18.9) and 11.7 (19.5) respectively. Stepwise multivariate analysis demonstrated that severe HIE (adjust odd ratio; 57.75,95%CI; 3.8,867.4, p=0.003), serum ammonia> 172.5 ug/dl (adjust odd ratio; 52.02, 95%CI; 3.4,802.5, p=0.005) and requirement of more than one anti-epileptic drugs (adjust odd ratio; 0.052, 95%CI; 0.004-0.762, p=0.031) were risk factors of death.
Conclusion: The mortality rate of HIE newborns in Chiang Mai University Hospital was 16%. Poor outcome group might be predicted by severity and serum ammonia level. Further study of prognostic score from affected factors is necessary for outcome prediction on HIE newborn patients.
Keywords: Perinatal asphyxia, HIE; hypoxic ischemic encephalopathy, mortality rate, newborn
