While I was browsing I saw this Article by Marcio Sotero de Menezes, MD, Assistant

Posted by Yafaau's Dad on May 26, 2003 in Blogger, General, Website |

Professor, Department of Neurology, Division of Pediatric Neurology, Children's Hospital of Seattle, University of Washington Background: The terms hypoxic-ischemic encephalopathy (HIE) of the newborn and perinatal asphyxia have been used synonymously in the past, rather loosely. Clinical signs of HIE often are wrongfully considered to be always the result of intrapartum asphyxia. This misconception has led to HIE being considered a marker of perinatal obstetric mismanagement, leading to many medicolegal problems. In reality, establishing a clear relationship between perinatal brain injury and ischemia/hypoxemia is often difficult. The term birth asphyxia is also imprecise, and its use is not recommended, because it implies that intrapartum anoxia has occurred. In the immediate newborn period, many factors can produce neurological symptoms mimicking HIE, including prepartum and postpartum ischemia/hypoxemia, genetic factors, metabolic disease, and maternal and fetal drug use. Since establishing the relationship between asphyxia and HIE is not always possible, the term newborn encephalopathy (NE) was proposed as an alternative to remove the medicolegal implications of HIE. Newborn encephalopathy is a clinically defined syndrome of disturbed neurological function in full-term infants that attempts to correlate symptoms in the neonatal period that have some relationship with neurological outcomes in childhood. NE symptoms may or may not be linked causally to hypoxemia/ischemia. Far from "fixing" the problem, the use of the term NE just removes the unfair blame for poor neonatal outcomes from obstetric practitioners. The National Collaborative Perinatal Project (NCPP), a prospective study of more than 50,000 pregnancies and 40,000 infants, analyzed the features of NE and found that the following were associated with increased morbidity on follow-up examinations: decreased activity after the first day of life, need for incubator more than 3 days, feeding problems, poor suck, and respiratory difficulties. Other factors not mentioned in the NE syndrome description have been associated with post neonatal morbidity such as static motor deficits (cerebral palsy [CP]), mental retardation, and epilepsy. These factors include neonatal seizures, low 10-minute Apgar scores, stupor, and coma. Read more http://author.emedicine.com/neuro/topic696.htm