Perinatology.  2022 Mar;33(1):9-14. 10.14734/PN.2022.33.1.9.

Brain Injuries in Term Infants with Respira tory Distress Immediately after Birth

• Jung N
• Lee J
• Lee G
• Nam SK
• Jun YH

• KMID: 2527762
• DOI: http://doi.org/10.14734/PN.2022.33.1.9

Abstract

Objective
We aimed to identify the prevalence of brain injuries and its associated factors in term infants with respiratory distress.
Methods
We retrospectively reviewed 98 infants born after 36 weeks’ gestation, who were admitted to the neonatal intensive care unit with a chief complaint of respiratory distress between January 2015 and December 2019. Brain magnetic resonance imaging findings, baseline demographics, and clinical characteristics were compared between infants with and without brain injuries.
Results
The proportion of infants having brain injuries among term infants with respiratory distress was 46.9% (46/98). The 1-minute Apgar scores (median [interquartile range]) were significantly lower (8 [5.0-9.0] vs. 9 [7.5-9.0], P=0.033) and maternal placental abruption was more frequent (6 [13.0%] vs. 1 [1.9%], P=0.049) in infants with brain injuries. Respiratory rates were lower (67 [48-78]/min vs. 78 [60-90]/min, P=0.009) and metabolic acidosis was more severe (pH: 7.21 [7.13-7.26] vs. 7.24 [7.20-7.30], P=0.027; base excess: -4.2 [-13.1 to -1.8] mEq/L vs. -2.7 [-5.5 to -1.2] mEq/L, P=0.072) in infants with brain injuries compared with infants without brain injuries.
Conclusion
Brain injury occurred in about half of the infants with unexpected respiratory distress immediately after birth. More severe metabolic acidosis, which was not compensated for by tachypnea, was associated with brain injuries in term infants. Preemptive evaluation is necessary to identify brain injuries in infants with respiratory distress.

Keyword

Respiratory insufficiency; Respiratory distress syndrome; Infant; Brain injuries