How and When Does Antenatal Hypoxia Damage Fetal Brains?

Abstract

Many seem to believe that asphyxia during labor and delivery is a frequent cause of non-progressive neurologic impairments. This assumption needs close examination because very few impaired individuals have placental abruptions, umbilical cord compression, or any other cause of intrapartum asphyxia diagnosed at birth, and only a small minority are in coma or have kidney failure in the neonatal period (Naeye 1986; Niswander 1983; Tack et al. 1986). Stupor or coma would be frequent if intrapartum asphyxia caused their impairments because the cerebral edema and uneven blood flow that damage the brain in these circumstances markedly depress brain function (Van Bel et al. 1984). Renal failure would also be frequent because severe intrapartum hypoxia almost always produces renal failure (Tack et al. 1986).