Hypoxic-ischemic encephalopathy (HIE) is a clinically defined syndrome of disturbed neurological function in the earliest days of life in the term infants manifested by respiratory distress, subnormal level of consciousness, seizures and depression of tone and reflexes. The authors identified antepartum and intrapartum risk factors for HIE in full term newborns. Between January 1st, 2001 and December 31st, 2003, 54 term infants (gestational age >37 weeks) in NICU of the Clinic of Neonatology, Department of Obstetrics and Gynecology, Prof. Paraskev Stoyanov Medical University of Varna were retrospectively studied. All of them met the criteria for moderate or severe HIE (seizures, abnormal consciousness (stupor, coma), respiratory distress, difficulty feeding, abnormal tone and reflexes). Birth prevalence of moderate or severe neonatal HIE was 4,42% term live births. More important antepartum risk factors for HIE were infections, preeclampsia, bleeding in pregnancy, and postmaturity. HIE incidence in infants born after 42 weeks is by 2,5 fold higher. Significant intrapartum risk factors for HIE were intrapartum asphyxia (24% of cases with HIE - OR=6,91), operative vaginal delivery (OR=l,65) and emergency Caesarean section (OR=3,78). The study of the significant risk factors for HIE contributes to prevention of neonatal morbidity and mortality.
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