Birth Asphyxia and Hypoxic-Ischemic Brain Injury in the Preterm Infant

Clin Perinatol. 2016 Sep;43(3):529-45. doi: 10.1016/j.clp.2016.04.010. Epub 2016 Jun 10.

Abstract

Birth asphyxia, also termed perinatal hypoxia-ischemia, is a modifiable condition as evidenced by improved outcomes of infants ≥36 weeks' gestation provided hypothermia treatment in randomized trials. Preterm animal models of asphyxia in utero demonstrate that hypothermia can provide short-term neuroprotection for the developing brain, supporting the interest in extending therapeutic hypothermia to preterm infants. This review focuses on the challenge of identifying preterm infants with perinatal asphyxia; the neuropathology of hypoxic-ischemic brain injury across extreme, moderate, and late preterm infants; and patterns of brain injury, use of therapeutic hypothermia, and approach to patient selection for neuroprotective treatments among preterm infants.

Keywords: Asphyxia; Hypoxia-ischemia; Neuroprotection; Preterm infants; Therapeutic hypothermia.

Publication types

  • Review

MeSH terms

  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / diagnostic imaging
  • Asphyxia Neonatorum / physiopathology*
  • Brain / diagnostic imaging
  • Brain / physiopathology*
  • Female
  • Gestational Age
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / diagnostic imaging
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / physiopathology*
  • Hypoxia-Ischemia, Brain / therapy
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / physiopathology*
  • Leukomalacia, Periventricular / complications
  • Leukomalacia, Periventricular / diagnostic imaging
  • Leukomalacia, Periventricular / physiopathology*
  • Magnetic Resonance Imaging
  • Pregnancy