Previously the central nervous system, with its involvement manifested by seizures and lethargy, has been the organ system most frequently recognized in association with perinatal asphyxia. The multiple organ system involvement in human neonates was implied from recent fetal monkey organ blood flow data following intrauterine asphyxia. A review of 6315 deliveries over the 21 mth from 1 January, 1973 elucidate the potential spectrum of organ involvement. Out of 59 term infants found with 5 min Apgar scores of 5 or less, 38 had symptoms within the first 5 days of life. These symptoms were sufficient to differentiate them from the normal infant and involved 5 organ systems. The frequency of involvement was as follows: pulmonary, 39%; cardiovascular, 34%; CNS, 24%; GI, 20%; and renal, 15%. 53% of the patients with symptoms had involvement of more than one system. When the combined 1 + 5 min Apgar score was used, 78% of infants with a value of 5 or less had symptomatic involvement, while only 25% with a combined Apgar score of 6 or more exhibited symptoms. If only the 5 min Apgar score was used, only 63% of the infants were identified. From the data presented, it is evident that intrauterine asphyxia affects multiple organ systems in the human full term infant. A combined 1 + 5 min Apgar score is more useful as a predictor of involvement than the 5 min Apgar score alone. The particular organ involvement could not be predicted from the Apgar score. With multiple organ involvement the CNS was not invariably included.
|Original language||English (US)|
|State||Published - Jan 1 1976|
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