Early period survival and neurologic prognosis in newborns with perinatal asphyxia: A tertiary center experience and a mortality chart

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dc.authorid0000-0002-7550-6765
dc.authorid0000-0002-1720-9711
dc.authorid0000-0002-4225-4143
dc.contributor.authorYaman, Akan
dc.contributor.authorKandemir, İbrahim
dc.contributor.authorAlp Ünkar, Zeynep
dc.date.accessioned2024-12-10T08:13:34Z
dc.date.available2024-12-10T08:13:34Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: Clinicians require more data regarding mortality and brain damage risk factors in perinatal asphyxia. Objectives: To assess early term outcomes and identify mortality risk factors in perinatal asphyxia. Methods: This study was conducted in a referral-center tertiary intensive care unit in Istanbul, Turkey, between 2016 and 2023. We included all patients who underwent therapeutic hypothermia treatment due to perinatal asphyxia. We recorded laboratory follow-up data, magnetic resonance imaging (MRI) findings, amplitude-integrated electroencephalograms (aEEG) results, mortality, and clinical outcomes. Both conventional frequentist statistical methods and Bayesian methods were used for analysis. Results: A total of 164 patients were included in the study, with an overall mortality rate of 9.8%. Risk factors for mortality included LDH, troponin I, INR, lactate, 2nd day creatinine, voltage anomalies, seizures, and male gender, as well as APGAR scores. A basic chart for mortality prediction was developed. The Sarnat score showed strong evidence, and APGAR 1 showed anecdotal evidence for association with brain damage, although brain damage was independent of laboratory results and other clinical findings, based on moderate and anecdotal evidence from Bayesian calculations. Cranial MRI findings revealed profound damage in 14.8% of Sarnat 1, 21.8% of Sarnat 2, and 50% of Sarnat 3 patients. Conclusions: This study presents prognostic factors for survival and brain damage in perinatal asphyxia. We recommend obtaining cranial MRI for all patients diagnosed with asphyxia, as most laboratory tests were independent of brain damage. Given that profound brain damage can occur even in Sarnat stage I patients, we emphasize the importance of therapeutic hypothermia for these patients.
dc.identifier.citationYaman, A., Kandemir, I., & Alp Ünkar, Z. (2025). Early period survival and neurologic prognosis in newborns with perinatal asphyxia: A tertiary center experience and a mortality chart. Iranian Journal of Pediatrics, 35(1), pp. 1-11. https://doi.org/10.5812/ijp-147020.
dc.identifier.doi10.5812/ijp-147020
dc.identifier.endpage11
dc.identifier.issn2008-2142
dc.identifier.issue1
dc.identifier.scopus2-s2.0-85210447103
dc.identifier.scopusqualityQ3
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.5812/ijp-147020
dc.identifier.urihttps://hdl.handle.net/20.500.13055/862
dc.identifier.volume35
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorKandemir, İbrahim
dc.institutionauthorid0000-0002-1720-9711
dc.language.isoen
dc.publisherBrieflands
dc.relation.ispartofIranian Journal of Pediatrics
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectInfant
dc.subjectNewborn
dc.subjectPerinatal Asphyxia
dc.subjectTherapeutic Hypothermia
dc.titleEarly period survival and neurologic prognosis in newborns with perinatal asphyxia: A tertiary center experience and a mortality chart
dc.typeArticle
dspace.entity.typePublication

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