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Table 2 Clinical and labor characteristics evaluated as risk factors for hypoxic ischemic encephalopathy

From: Intrapartum factors associated with neonatal hypoxic ischemic encephalopathy: a case-controlled study

Characteristic

Cases

(N = 26)

N (%)

Controls

(N = 104)

N (%)

Univariate analysis

Multivariable analysisg

Unadjusted OR (95% CI)

P

Adjusted OR (95% CI)

P

Prior cesarean delivery

6 (23.1%)

11 (10.6%)

2.53 (0.83, 7.75)

0.10

  

Chronic hypertension

2 (7.7%)

1 (1.0%)

8.00 (0.72, 88.23)

0.09

  

Gestational diabetes

1 (3.8%)

4 (3.8%)

1.00 (0.02, 10.11)

1.00

  

Fetal growth restriction

0 (0%)

2 (1.9%)

1.66 (0, 13.89)

1.00

  

Oligohydramnios

1 (3.8%)

2 (1.9%)

2.00 (0.18, 22.06)

0.57

  

Preterm labor

2 (7.7%)

4 (3.8%)

2.67 (0.33, 21.54)

0.36

  

Meconium-stained amniotic fluida

11 (42.3%)

16 (15.4%)

4.62 (1.63, 13.06)

0.004

12.41 (2.10, 144.83)

0.002

Chorioamnionitis

2 (7.7%)

3 (2.9%)

3.15 (0.43, 23.36)

0.26

  

Oxytocin use

14 (53.8%)

50 (48.1%)

1.26 (0.53, 3.00)

0.60

  

Abnormal first stage of laborb,c

12/17 (70.6%)

48/94 (51.1%)

2.19 (0.71, 6.76)

0.17

  

Prolonged second stage of labord

5/17 (29.4%)

4/91 (4.4%)

11.24 (1.92, 65.58)

0.007

9.49 (1.06, 135.30)

0.042

Any sentinel or acute evente

6 (23.1%)

0 (0%)

32.66 (6.18, infinity)

< 0.001

74.86 (11.86, infinity)

< 0.001

Any ‘category 3’ segment in the last hour of laborf

7/25 (28.0%)

4/101 (4.0%)

7.30 (2.11, 25.30)

0.002

  
  1. aMeconium-stained amniotic fluid present either before or after 6 cm of dilation
  2. bThe first stage of labor could not be classified for 9 HIE cases and 10 controls because they either have a cesarean section without laboring (N = 5 cases and N = 6 controls) or they first presented at 10 cm (N = 2 controls) or they never reached an active phase before proceeding to a cesarean section (N = 1 case and N = 1 control) or they only had 1 measurement in the active phase before proceeding to a cesarean section (N = 3 case and N = 1 control)
  3. cAbnormal first stage of labor included patients with protracted labor (cervical dilation <1.2 cm per hour), secondary arrest (lack of cervical dilation for >2 h after patient reached 7 cm) and combined disorders (patients with both protracted labor and secondary arrest)
  4. dThe second stage of labor could not be classified for 9 HIE cases and 13 controls because they either have a cesarean section without laboring (N = 5 cases and N = 6 controls) or they did not reach 10 cm before proceeding to a cesarean section (N = 4 cases and N = 7 controls)
  5. eA sentinel event was defined as an acute event that emergently altered the course of labor; these included uterine rupture, cord prolapse, placental abruption, fetal exsanguination/vasa previa, amniotic fluid embolism, and maternal collapse
  6. fOne HIE case and 3 controls had insufficient information for categorizing the fetal heart tracings
  7. gMultivariable exact conditional logistic regression models were fit considering all variables with p < 0.20 based on univariate analysis and first examining all one-variable models, all two-variable models, and all three-variable models. Variables were retained in the final multivariable model if p < 0.05
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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