Features of the Early Neonatal Period Course in Infants with Severe Birth Asphyxia

Introduction . Severe birth asphyxia, as one of the main causes of perinatal morbidity and mortality, presents a serious problem in neonatology. Study Objective : To identify the characteristics of the early neonatal period and its outcome in full-term newborns with severe birth asphyxia. Materials and Methods . A prospective single-center study was conducted. The main group consisted of 30 newborns who experienced severe birth asphyxia, and the control group for comparison of blood gases and acid-base balance comprised 60 newborns without asphyxia. Statistical processing of the results was carried out using the “Microsoft Excel 2016” application software package. The following were calculated: mean value (M), Standard deviation (SD), frequencies (%), and Student’s t-test. The critical significance level for testing statistical hypotheses was taken as 0.05. Results . Maternal medical history and the course of the current pregnancy were analyzed. Predominantly endocrine pathology was identified, including gestational diabetes mellitus in 95% of cases and obesity of varying severity. Delivery was operative in 53% of cases. In 57% of cases, complications included the development of fetal distress. The condition of newborns at birth reflected severe hypoxia: average Apgar scores were 2.43±0.77 at one minute, 4.76±1.22 at five minutes, and 6.2±1.22 at ten minutes. Respiratory support was required for all patients: in the delivery room, invasive mechanical ventilation (MV) was used in 73%, and continuous positive airway pressure (CPAP) in 37%. This was followed by transfer to the Neonatal Intensive Care Unit (NICU), where ventilation duration reached 20 days in severe cases. Passive hypothermia was initiated in 70% of newborns, and therapeutic hypothermia in 33%, which aligns with current neuroprotection protocols and emphasizes the need for early intervention to minimize neurological deficits. Neurosonography revealed cerebral ischemia in 90% of infants, with cerebral edema in 47% and periventricular lesions in 60%, illustrating a direct link between asphyxia and cerebral complications and multi-organ dysfunction. Conclusion . In the vast majority of newborns, the early neonatal period concluded with the development of cerebral ischemia, predominantly of moderate severity (grade II), with periventricular brain injury detected in a significant number of cases. Further study and analysis of newborns who experienced severe birth asphyxia are necessary to identify predictors of adverse neurological outcomes.