Newborn asphyxiation, also referred to as asphyxia neonatorum, is a failure of an infant to start regular respiration within one minute of birth. This condition is considered a neonatal emergency and can lead to hypoxia and possible brain damage or death if not managed correctly and in a timely manner. Typically, newborns will start to breathe without assistance and are breathing well within one minute following birth. Infants that fail to establish sustained respiration after birth are diagnosed with birth asphyxiation.
Childbirth Asphyxiation Statistics
According to the National Center for Health Statistics, infant mortality caused by asphyxia neonatorum was the tenth leading cause of infant mortality and amounted to 14.4 deaths per 100,000 live births in the United States. The World Health Organization has stated that this condition is one of the leading causes of newborn deaths among developing countries, accounting for approximately 20 percent of the infant mortality rate. As of 2010, globally, birth asphyxia accounted for 10 percent of deaths in children under the age of five; nine percent of which were during the neonatal period.
Risks and Symptoms
Common causes of birth asphyxia include prenatal hypoxia (reduction of the oxygen supply to bodily tissues), umbilical cord compression during birth, a preterm or otherwise difficult delivery, and maternal anesthesia.
Certain women are at a higher risk for this condition including:
- Those under the age of 16 or older than 40
- Maternal illnesses such as diabetes, hypertension, and severe anemia
- Mothers with previous stillbirths, early neonatal deaths, or preterm birth
- Lack of prenatal care
- Alcohol abuse while pregnant
- Smoking while pregnant
- Abnormal fetus presentation or position
Birth asphyxiation is indicated by symptoms such as cyanosis (bluish or gray skin color), a slow heartbeat, hypotonia (stiff or limp limbs), and a poor stimulation response.
Diagnosis and Treatment
Diagnosis of birth asphyxia is largely determined by the infant’s Apgar score which measures the physical health of an infant by examining their adequacy of respiration, heart action, muscle tone, skin color, and reflexes. A normal Apgar score is seven to ten, while infants with a score between four and six have a moderate decrease in their vital signs, and those with a score of zero to three are at a much greater risk of death unless they are resuscitated in the delivery room.
Treatment for asphyxiation at birth involves resuscitation of the infant. Most, if not all modern delivery rooms are equipped with the necessary tools to properly resuscitate an infant, and what began as teaching methods has grown to organized programs and procedures for properly doing so. The most widely used procedure for resuscitating newborns is supported by both the American Heart Association and the American Academy of Pediatrics. Other than resuscitation treatment for this condition can also include giving the mother additional amounts of oxygen prior to delivery, delivering medications that support the baby’s breathing and sustain blood pressure, and ECMO or extracorporeal membrane oxygenation which is a similar technique to a heart-lung bypass machine. Such a technique assists with the infant’s heart and lung functions by utilizing an external pump and oxygenator.
Prognosis will depend greatly upon how long the infant is without oxygen, and anticipation is the key to preventing this condition. High-risk pregnancies should be carefully monitored and delivered in medical facilities properly outfitted to provide resuscitation should it be necessary.