Birth asphyxia is a serious medical condition that can occur when a baby’s breathing is interrupted during or after birth. Sometimes, it can result in death.
Although it is a rare condition, parents need to be aware of the symptoms and risk factors so they can seek medical attention immediately if they think their baby may be affected. In this article, we will discuss the causes, symptoms, and treatment options for birth asphyxia.
What is birth asphyxia?
Birth asphyxia, also known as perinatal asphyxia or asphyxia neonatorum, is defined as failure to start and maintain spontaneous respiration following birth. This can lead to problems with the baby’s heart, lungs, and brain. In severe cases, birth asphyxia can lead to death.
It can occur when a baby’s brain does not receive enough oxygen before, during, or after birth. Lack of oxygen can damage the brain and other organs.
Perinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely. WHO estimates that 4 million neonatal deaths occur yearly due to birth asphyxia, representing 38% of deaths of children under 5 years of age.
What are the signs and symptoms of birth asphyxia?
The most common sign of birth asphyxia is low Apgar scores. The Apgar score is a quick way to determine how well a baby is doing outside of the womb. It is based on five signs:
- Heart rate
- Respiratory effort
- Muscle tone
- Reflexes
- Skin color
The Apgar score is given at one and five minutes after birth. A score of seven or above is considered normal, four to six is low, and three or below is very low.
Other birth asphyxia symptoms include:
- Seizures
- The increased acid level in a baby’s blood
- Weak cry
- Poor muscle tone
- Slow heartbeat
- Low body temperature (hypothermia)
- Dilated pupils
What causes birth asphyxia?
There are many possible causes of birth asphyxia. Some of the most common include:
- Placental abruption: It is when the placenta tears away from the wall of the uterus before delivery.
- Placental insufficiency: This is when the placenta does not provide enough oxygen or nutrients to the baby
- Umbilical cord problems: Umbilical cord prolapse (when the umbilical cord drops into the birth canal before or during delivery), nuchal cords (twisted umbilical cord around the baby’s neck), and true knot in the cord can all cause birth asphyxia.
- Prolonged labor: This is when labor lasts more than 18 hours for a first-time mother or more than 14 hours for a mother who has had a vaginal delivery before
- Meconium aspiration: This is when a baby inhales meconium, which is the first stool made by the intestines. Meconium is sticky and can block the airways.
- Breech presentation, which is when the baby is born bottom first instead of head first
- Maternal bleeding
- Maternal diabetes
- Low blood pressure in the mother
What are the risk factors for birth asphyxia?
Several risk factors can increase the likelihood of birth asphyxia. These include:
- Premature birth
- Maternal age less than 20 or greater than 35
- Small size for gestational age (SGA)
- History of maternal smoking
- Use of illicit drugs during pregnancy
- Obesity in the mother
- Poor nutrition in the mother
- Preeclampsia
- Medications
Babies born to mothers with conditions that affect pregnancy, such as diabetes mellitus or preeclampsia, are also at greater risk. If you are pregnant, it is important to talk to your healthcare provider about any risk factors you may have. They can help you plan for safe and healthy delivery.
What are the complications of birth asphyxia?
Birth asphyxia can cause several complications, both in the short and long term. These include:
- Cerebral palsy
- Seizures
- Mental retardation
- Behavioral problems
- Learning disabilities
- Attention deficit disorder (ADD)
- Hearing loss
- Vision problems
In some cases, birth asphyxia can be fatal. According to WHO, perinatal asphyxia is responsible for about 23% of neonatal deaths worldwide.
How to prevent birth asphyxia?
Several things can be done to prevent birth asphyxia. These include:
- Getting early and regular prenatal care. This can help identify any problems that may put you at risk for birth asphyxia.
- Controlling diabetes and high blood pressure. If you have diabetes or high blood pressure, working with your healthcare provider to control it can help reduce the risk of birth asphyxia.
- Avoid smoking, illicit drugs, and alcohol. Smoking, using illicit drugs, and drinking alcohol during pregnancy can all increase the risk of birth asphyxia.
- Having a healthy lifestyle. Eating a balanced diet and getting regular exercise can help reduce the risk of birth asphyxia.
Birth asphyxia is a serious condition that can cause long-term complications. While it cannot always be prevented, there are things you can do to reduce your risk. If you are pregnant, talk to your healthcare provider about ways to keep you and your baby safe during delivery.
How is birth asphyxia diagnosed?
If your baby has low Apgar scores, your healthcare provider will closely monitor them. They may also do a physical examination and order tests, such as:
- Blood tests
- Urine tests
- X-rays
- CT scan or MRI of the brain
- EEG
- Echocardiogram
How is birth asphyxia treated?
The treatment for birth asphyxia will depend on the severity of the condition. In some cases, no treatment may be necessary. For milder cases, your healthcare provider may give you and your baby oxygen. If the asphyxia is more severe, your baby may need to be intubated and placed on a mechanical ventilator to help them breathe. They may also need:
- IV fluids
- Nutrition through a feeding tube
- Medication to control seizures
- Antibiotics to prevent infection
- Inhaled nitric oxide is provided by a breathing tube placed directly into the baby’s windpipe to help lower blood pressure and open the blood vessels in the lungs.
- Extracorporeal membrane oxygenation (ECMO) machine: This is a machine that takes over the function of the lungs and heart. It is used for babies who are very sick and have not responded to other treatments. The machine delivers oxygen to the baby’s brain and body as temporary support.
In some cases, cooling blankets may be used to help reduce the risk of brain injury. This treatment is called therapeutic hypothermia and is only used for babies with severe asphyxia.
What is the outlook for a baby with birth asphyxia?
The outlook for a baby with birth asphyxia will depend on the severity of the condition. In mild cases, there may be no long-term effects. However, in more severe cases, birth asphyxia can cause a variety of complications, some of which may be permanent. These can include cerebral palsy, seizures, mental retardation, and learning disabilities. In some cases, birth asphyxia can be fatal.
