Antenatal and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy.

Objective: To identify antenatal and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy (HIE).

Study Design: A single center, retrospective cohort study was conducted for 25,494 singleton births ≥36 weeks' gestation born between 2009 and 2016. Univariate and multivariate analyses were performed to identify risk factors for HIE.

Results: Thirty-seven infants met HIE inclusion criteria. Independent antenatal risk factors included primigravida, previous fetal death/stillbirth, antidepressant use, illicit drug use, Rh sensitization, and adjusted gestational weight gain >13.6 kg. Independent intrapartum risk factors identified were placental abruption, ruptured uterus, moderate-to-heavy meconium stained amniotic fluid, and delivery by cesarean-section. An intrapartum risk factor was present in 70.3% of the HIE group compared with 29.6% of the non-HIE group.

Conclusion: Intrapartum period risk factors appear to be important for the development of HIE. Gestational weight gain may serve as an important modifiable factor to reduce the risk of HIE.