MULTIORGAN
INVOLVEMENT AFTER PERINATAL ASPHYXIA IN NEWBORN
Sun MY, Shao J
Children’s Hospital,
Medical College of Zhejiang University, Hangzhou, China
Objectives: ⑴
To evaluate the frequency and the severity of the multisystem dysfunction
after perinatal asphyxia and ⑵
to analyze the relationship between the clinical and biochemical parameters
of perinatal asphyxia and multiorgan involvement.
Method: 214 term newborn infants with perinatal
asphyxia admitted to Neonatal Intensive Care Unit (NICU) from 1989 to 1998
were studied retrospectively.
Results: ⑴
Multiorgan involvement: 46(21%) infants had no signs of organ dysfunction,
68 (32%) involved one organ, and 100 (47%) involved two or more organs. ⑵ Classification of organ
dysfunction: Central nervous system injury occurred in 137 (64%) infants,
pulmonary in 93 (43%) infants, renal in 76 (35%) infants, Gastrointestinal
in 33 (15%) infants and cardiac in 29 (14%) infants. ⑶ The relationship between involvement of organs
and mortality : Twenty-nine (14%) infants died. The mortality was
significantly associated with the number of organs of failure (x2=126.39,
P<0.001). (4) A stepwise liner regression analysis showed: The Apgar
Score at five minutes, as well as PH at the time of admission, was significantly
related to the number of organs involved and the severity of involvement
(P<0.001).
Conclusions: The Apgar Score at five minutes and PH at the time of
admission, in infants who have other clinical criteria for asphyxia, are
the perinatal markers that may best indicate the number of organs involved
and the severity of the organ involvement.