Severe neonatal asphyxia. Incidence and prediction of outcome in the Stockholm area.

In Sweden during the 1970's the incidence of severe asphyxia (an Apgar score of 3 or less at 5 min) has decreased significantly from 3.22 to 2.56 per 1000 infants. A follow-up study was undertaken concerning 116 infants (40 preterm, 76 full-term) admitted to St. Göran's Children's Hospital during a 7-year period (1973-79). The mortality rate was 48% in preterm and 21% in full-term infants. Significant sequelae were present in 27% of the surviving full-term and 14% of the preterm infants. The three severely-handicapped preterm infants had other serious diseases as well whereas this applied to only one full-term infant. The predictors of sequelae included perinatal complications, late onset of spontaneous ventilation (greater than 20 min) and postnatal symptoms, such as seizures. Only two of 9 infants with regular breathing after 20 min and three of 16 infants with seizures were considered normal at follow-up.