Abstract:OBJECTIVE: To analyze the effects of severe neonatal asphyxia on various organ-systems and to identify the risk factors associated with the resultant injuries and death. METHODS: The data of 170 cases in the last 10 years from January 1993 to March 2004 were analyzed. The risk factors associated with death were subjected to odds ratio (OR) analysis with the SAS software. RESULTS: There were 22 deaths in the 170 cases (12.5%). Organ-system injuries were evident in 165 of 170 cases (97.1%). In descending orders, the organ-system injuries were central nervous system [CNS,66.5%(113/170)], pulmonary [62.9%(107/170)] and metabolic disorders [50.6%(86/170)]. The severity of injuries was in the reversed orders from metabolic disorders, pulmonary to CNS. From high risk to low, the factors which affected the mortality of severe asphyxia were, in order, severe CNS injury, ≥1 organ/system injury, respiratory failure, metabolic abnormality, electrolyte imbalance, blood-gas abnormality, pulmonary involvement, 10 min Apgar score≤3, gestational age<37 weeks, hepatic involvement, cardiac involvement, raised PCO_2, and hematologic involvement. CONCLUSIONS: Organ-system injuries in addition to hypoxic-ischemic encephalopathy (HIE) were complications found in the majority of the cases with severe neonatal asphyxia. The risk factors such as CNS injury or HIE, pulmonary dysfunction and failure, and multiorgan dysfunction syndrome (MODS) involving more than three organ-systems should be detected and recognized early so that early intervention can be instituted to reduce the mortality
