Perinatal Injury

Perinatal brain injuries are suffered by an infant in the time right before or immediately following birth. Our Neonatal Neurology Program works closely with a comprehensive team of neonatal specialists to take extra special care of children born with serious brain conditions.

The most common is perinatal hypoxia, a deficiency of oxygen to the brain tissue before and after birth that causes a baby to stop breathing.

HIE is a type of brain damage that often leads to other complications like developmental or cognitive delays and disabilities, and motor impairments as the child gets older.

Other medical conditions associated with perinatal hypoxia include:

• Cerebral palsy (CP): a neurological disorder due to a non-progressive brain injury that occurs while a child’s brain is still developing
• Severe seizures
• Behavioral disorders

Causes

There are a number of reasons that a child does not get an adequate amount of oxygen at birth, the most common including:

• Maternal smoking
• Maternal anemia, or iron deficiency during pregnancy
• Traumatic brain injury suffered during childbirth
• Inadequate fetal monitoring
• Umbilical cord issues such as a prolapse (when the umbilical cord emerges before the fetus during birth), or pinching leading to a disruption in oxygen flow
• Placental abruption (when the placenta detaches from the uterus, interrupting the flow of oxygen to the fetus)

Diagnosis

A diagnosis of perinatal hypoxia usually comes during childbirth or immediately following. Oxygen levels are monitored closely as soon as the baby emerges from the womb, and if any abnormalities are present, swift action will be taken.

Signs and symptoms of oxygen loss include:

• Behavioral abnormalities, such as poor feeding, irritability, or excessive crying or sleepiness (typically in an alternating pattern)
• Lethargy, with significant hypotonia (the baby having a “rag doll” or floppy-like feel when held)
• Sluggish or absent grasping, moro, or sucking reflexes
• Occasional periods of apnea, pauses in breathing as the baby sleeps
• Seizures occurring within the first 24 hours after birth

Perinatal Brain Injury Treatment

Immediate action within the first six hours following birth is critical if oxygen loss is suspected.

Neonatal therapeutic hypothermia is the most common form of treatment used for perinatal hypoxia and can effectively reduce mortality rates and long-term neurological disorders by half.

The term hypothermia refers to freezing, and this treatment involves cooling the newborn’s body temperature in a very controlled environment with special ice blankets or an ice cap on the head to slow down cellular responses in the brain while oxygen can be administered. Once the oxygen level has reached normal amounts, the baby is gently warmed up and regular temperatures are restored.