Hypoxic-Ischemic Encephalopathy (HIE), also known as neonatal encephalopathy or birth asphyxia, is a type of brain injury resulting from oxygen deprivation. Newborns can manifest HIE in a number of ways, including but not limited to cerebral palsy, learning disabilities, delayed growth and development, and behavioral disorders.
HIE is unfortunately somewhat common, occurring in approximately 4 of every 1000 live births. This is a devastating condition usually caused by mismanaged labor and post-delivery care often on behalf of obstetricians, nurses, and midwives.
Misinterpretation of fetal heart rate tracing, failure to communicate abnormal symptoms, and failure to promptly intervene all put the baby at risk. HIE may also result from delayed cesarean sections or improper use of medication and delivery instruments like vacuums or forceps. In many of these cases, HIE is preventable.
Most newborns diagnosed with HIE now undergo therapeutic hypothermia (TH) or “cooling” to slow down and limit resulting brain damage and future motor and cognitive deficits. Often, cooling can even result in normal or near normal MRI findings.
While cooling is undoubtedly helpful, many children, however, still go on to develop motor, cognitive, and behavioral problems in later childhood and adolescence. Further, normal MRI findings do not necessarily equate to normal early childhood development.
Infants who are subject to hypoxic-ischemic injury at or near the time of birth, with or without cooling, are often later diagnosed with cerebral palsy, a group of conditions involving permanent motor dysfunction that affect muscle tone, posture, and movement.
Cognitive impairment frequently occurs in individuals with HIE, and can be accompanied by neuromotor deficits such as cerebral palsy or other physical disabilities. Even children who suffered neonatal HIE without major disability are at increased risk for long-term deficits intellectually, verbally, and behaviorally.
