Changing pattern of perinatal brain injury in term infants in recent years

Toshiki Takenouchi, Ericalyn Kasdorf, Murray Engel, Amos Grunebaum, Jeffrey M. Perlman

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Perinatal brain injury in term infants remains a significant clinical problem. Recently a change appears to have occurred in the pattern of such injuries. We sought to characterize the incidence, etiology, clinical manifestations, and outcomes of these injuries. A retrospective chart review identified clinical characteristics of neuroimaging, electroencephalography, and placental pathologic findings. Perinatal depression was defined as hypotonia and the need for respiratory support. From January 2004-December 2009, 29,597 term deliveries occurred. Brain injuries in 33 infants (live term births) included hypoxic-ischemic encephalopathy (n = 8; 0.27/1000), subdural hemorrhage (n = 10; 0.34/1000), intraventricular/intraparenchymal hemorrhage (n = 5; 0.17/1000), and focal cerebral infarctions (n = 4; 0.14/1000). Thirteen of 33 infants (39%) were triaged to a regular nursery. Delayed presentations included apnea (n = 6), desaturation episodes (n = 3), and seizures (n = 4). Twenty of 33 (61%) were admitted directly to the neonatal intensive care unit because of perinatal depression or evolving hypoxic-ischemic encephalopathy. Clinical signs included seizures (n = 12) and apnea (n = 2). Nine of 19 manifested electroencephalographic seizures. Pathology included chorioamnionitis (n = 7) and fetal thrombotic vasculopathy (n = 5). The latter was associated with focal cerebral infarctions in 3/4 cases. Most cases attributable to perinatal brain injury, except for evolving hypoxic-ischemic encephalopathy, are not identified according to any perinatal characteristics until the onset of signs, limiting opportunities for prevention.

Original languageEnglish
Pages (from-to)106-110
Number of pages5
JournalPediatric Neurology
Volume46
Issue number2
DOIs
Publication statusPublished - 2012 Feb
Externally publishedYes

Fingerprint

Brain Hypoxia-Ischemia
Brain Injuries
Seizures
Cerebral Infarction
Apnea
Term Birth
Chorioamnionitis
Subdural Hematoma
Muscle Hypotonia
Nurseries
Neonatal Intensive Care Units
Wounds and Injuries
Live Birth
Neuroimaging
Electroencephalography
Pathology
Hemorrhage
Incidence

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

Cite this

Changing pattern of perinatal brain injury in term infants in recent years. / Takenouchi, Toshiki; Kasdorf, Ericalyn; Engel, Murray; Grunebaum, Amos; Perlman, Jeffrey M.

In: Pediatric Neurology, Vol. 46, No. 2, 02.2012, p. 106-110.

Research output: Contribution to journalArticle

Takenouchi, Toshiki ; Kasdorf, Ericalyn ; Engel, Murray ; Grunebaum, Amos ; Perlman, Jeffrey M. / Changing pattern of perinatal brain injury in term infants in recent years. In: Pediatric Neurology. 2012 ; Vol. 46, No. 2. pp. 106-110.
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