Affiliations: Vanderbilt University Medical Center, Nashville, TN,
USA | Creighton University Medical Center, Department of
Pediatrics, Omaha, NE, USA
Note: [] Corresponding author: John W. Schmidt, MD, Creighton University
Medical Center, Department of Pediatrics, 601 N. 30 St., Suite 6843, Omaha, NE
68131, USA. Tel.: +1 402 280 1231; Fax: +1 402 280 4855; E-mail:
johnschmidtmd@creighton.edu
Abstract: Objective: To determine both the incidence of perinatal hypoxic
ischemic encephalopathy (HIE) in a group of preterm infants 32–36 weeks
gestational age at a single center and the outcomes of these patients. Study design: The number of infants 32–36 weeks
gestational age without major congenital anomalies born at Vanderbilt
University Hospital between January 1, 2002 and June 30, 2008 was determined
and a retrospective chart review was performed on those infants with a 5-minute
Apgar score of less than 6. Infants were considered to have experienced
perinatal HIE if they met all of the following criteria: 5-minute Apgar score less than 6 Cord or initial patient blood pH less than 7.00 or base deficit
greater than 15 (mmol/L) Evidence of encephalopathy at or shortly after birth (seizures,
hypotonia) History of a sentinel event at the time of delivery No other cause of encephalopathy (sepsis, hypermagnesemia,
hemorrhage, hyponatremia, drug induced) Preterm infants with 5-minute Apgar score less than 6 not meeting
all of the criteria were considered not to have had perinatal HIE. A poor
outcome was defined as death, or cerebral palsy, or neurodevelopmental
impairment, or bilateral deafness, or bilateral blindness. If no follow-up data
was available, the patient was recorded as being alive at discharge and
considered to be normal. Results: Between January 1, 2002 and June 30, 2008 there were 1,325
infants 32–36 weeks gestational age born at Vanderbilt University Medical
Center. The incidence of perinatal HIE in these patients was 12/1325 (0.9%).
58.33% of these patients suffered poor outcomes. Conclusion: With a similar incidence and experience of adverse
sequelae as the term infant, preterm infants 32–36 weeks in gestation
with perinatal HIE should be considered for future randomized controlled
studies for treatment of this potentially devastating injury.
