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Master Thesis

Facteurs de risque d’encéphalopathie anoxo-ischémique en cas d’acidose néonatale sévère

Abstract : Introduction: our objectif was to identify risk factors of hypoxic-ischemic encephalopathy (HIE) in neonates with umbilical arterial pH =7.00. Patients and method: we performed a case-control study over a period of 5 years, including children =36 weeks born with an umbilical pH =7,00. Cases are infants who developed moderate or severe HIE. Controls did not develop moderate or severe HIE. Results: 41 cases and 98 controls were identified. Factors associated with moderate or severe HIE were: the occurrence of an acute event (34.1% vs 9.2% ORa = 6.4 [1.8-22.5]), maternal fever (24.4% vs 11.2% ORa= 3.5 [1.0-11.9]), meconium amniotic fluid (37.5% vs 15.6% ORa = 2.9 [1.0-8.6]) and the time between emergency caesarean section decision and birth (18.9 min vs 13.1 min p= 0.03). Children with moderate or severe HIE had lower mean umbilical pH (6.87 vs 6.93 p<0.001), higher cord lactate level (11.2 vs 9.3 p<0.001), and lower Apgar score at 5 minutes (4.1 vs 8.6 p<0.001). Conclusion: the occurrence of an acute event, maternal fever, meconium amniotic fluid and the time between emergency caesarean section decision and birth are the factors associated with moderate or sevre HIE for neonates with umbilical pH = 7.00 that our study has highlighted. On the neonatal side, the risk of HIE is related to the depth of acidosis, the importance of its metabolic component, the Apgar score and the gasometric data at one hour of life.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03204529
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Submitted on : Thursday, May 6, 2021 - 3:55:29 PM
Last modification on : Tuesday, September 7, 2021 - 3:23:51 AM

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  • HAL Id : dumas-03204529, version 1

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Perrine Lorain. Facteurs de risque d’encéphalopathie anoxo-ischémique en cas d’acidose néonatale sévère. Médecine humaine et pathologie. 2019. ⟨dumas-03204529⟩

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