[Multicenter study of asphyxia neonatorum].

Out of 14,673 term infants born at seven neonatal centers in the Barcelona area, 215 newborns were identified as being at risk of developing hypoxic-ischemic encephalopathy. They had shown one or more of the following criteria: fetal pH less than or equal to 7.20, abnormal fetal heart rate patterns, umbilical artery pH less than or equal to 7.20, 5 minute Apgar score less than or equal to 6, or the need for immediate neonatal resuscitation. 135 items were investigated in relation to epidemiological, clinical and laboratory parameters. The incidence of HIE was 6.39% and the mortality was 0.55%. Abnormal neurologic examination was present in 43.7% of 215 term infants at risk, and in 1/10 of them the symptoms were severe. The predictive accuracy of the criteria used in the study was: the most sensitive criteria were the fetal distress and umbilical artery pH, the most specific criteria were the need for immediate neonatal resuscitation and a 5 minute Apgar score less than or equal to 6, and the most efficient criteria were the need for immediate neonatal resuscitation and fetal pH less than or equal to 7.20.