COMPARISON OF TWO METHODS OF PREDICTING OUTCOME IN PERINATAL ASPHYXIA

In a follow-up study of 122 full-term infants in whom postasphyxial encephalopathy occurred the incidence of death or severe handicap was 1 in 1000 deliveries. The abilities of two methods of diagnosing intrapartum asphyxia to predict outcome at a median age of 2.5 years were compared. A decision matrix calculation was undertaken to assess the sensitivity and specificity of low Apgar score and postasphyxial encephalopathy. A 10 min Apgar score less than or equal to 5 was the most sensitive of six different Apgar ratings in predicting adverse outcome (sensitivity 43%, specificity 95%) but even this was much less sensitive than the presence of moderate or severe encephalopathy in predicting death or severe handicap (sensitivity 96%).

[1]  E. Keeler,et al.  Primer on certain elements of medical decision making. , 1975, The New England journal of medicine.

[2]  Harvey B. Sarnat,et al.  NEONATAL ENCEPHALOPATHY FOLLOWING FETAL DISTRESS , 1977 .

[3]  H. Sarnat,et al.  Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. , 1976, Archives of neurology.

[4]  G. Fenichel Hypoxic-ischemic encephalopathy in the newborn. , 1983, Archives of neurology.

[5]  M L Levene,et al.  The incidence and severity of post-asphyxial encephalopathy in full-term infants. , 1985, Early human development.

[6]  D A HOLADAY,et al.  The acid-base status of human infants in relation to birth asphyxia and the onset of respiration. , 1958, The Journal of pediatrics.

[7]  N. Finer,et al.  Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome. , 1981, The Journal of pediatrics.

[8]  H. Scott,et al.  Outcome of very severe birth asphyxia. , 1976, Archives of disease in childhood.

[9]  DO APGAR SCORES INDICATE ASPHYXIA? , 1982, The Lancet.

[10]  A. Allen,et al.  Neonatal asphyxia. I. Relationship of obstetric and neonatal complications to neonatal mortality in 38,405 consecutive deliveries , 1980 .

[11]  R. Rivers,et al.  FETAL ASPHYXIA IN LABOUR , 1979, The Lancet.

[12]  N. Finer,et al.  Factors affecting outcome in hypoxic-ischemic encephalopathy in term infants. , 1983, American journal of diseases of children.

[13]  R. Zetterström,et al.  SEVERE NEONATAL ASPHYXIA , 1983, Acta paediatrica Scandinavica.

[14]  N. Finer,et al.  TERM INFANTS WITH HYPOXIC‐ISCHEMIC ENCEPHALOPATHY: OUTCOME AT 3.5 YEARS , 1985, Developmental medicine and child neurology.

[15]  F. Cockburn,et al.  Neurological Aspects of Perinatal Asphyxia , 1974, Developmental medicine and child neurology.

[16]  J H Ellenberg,et al.  Apgar scores as predictors of chronic neurologic disability. , 1981, Pediatrics.