Echocardiographic evaluation of myocardial dysfunction in term neonates with perinatal asphyxia

Cardiac Dysfunction in Perinatal Asphyxia

  • Javaria Rasheed Nishtar Medical University Multan
  • Muhammad Khalid Nishtar Medical University & Hospital Multan
  • Iram Nawaz Bakhtawar Amin Medical & Dental College
  • Barera Maryam Nishtar Medical University & Hospital Multan
Keywords: Asphyxia neonatorum, Echocardiography, Pulmonary hypertension, Neonates, Cardiac dysfunction

Abstract

Background & Objective: One third of the neonatal deaths worldwide are attributed to perinatal asphyxia. We aimed to determine the prevalence and determinants of cardiac dysfunction, through echocardiographic evaluation, in term neonates with perinatal asphyxia.

Methods: This cross-sectional study was conducted at a tertiary care setting over a period of six months from 1st January 2021 to 30th June 2021. Term neonates, weighing ≥ 2500 grams, born with Apgar score < 7 and admitted within 48-hours of life were consecutively enrolled. Using Levene classification neonates were grouped into moderate and severe perinatal asphyxia. All neonates underwent transthoracic echocardiographic evaluation after 24-hours of stabilization and within 72-hours of life. Descriptive statistics are calculated, and logistic regression analysis is done to determine the risk factors of myocardial dysfunction.

Results: Among 166 neonates, 53% (n=88) were males, mean gestational age was 38.1 ± 0.89 weeks. Moderate asphyxia was present in 121 (72.9%). Most common echocardiographic finding was pulmonary hypertension in 50% followed by patent ductus arteriosus (PDA) in 37.2% and mitral regurgitation in 6.6%. Myocardial dysfunction was detected in 28.9% of the neonates. Three independent determinants of myocardial dysfunction were severe asphyxia [adjusted odds ratio (aOR) 5.01, 95% CI 2.2-11.4; p-value <0.001], having patent ductus arteriosus (aOR 5.11, 95% CI 2.2-11.8; p-value < 0.001) and delivery through cesarean section (aOR 2.65, 95% CI 1.2-5.9; p-value 0.02).

Conclusions: Myocardial dysfunction among neonates with perinatal asphyxia is common and severity of asphyxia, mode of delivery and presence of patent ductus arteriosus are important determinants.

doi: https://doi.org/10.12669/pjms.40.9.9501

How to cite this: Rasheed J, Khalid M, Nawaz I, Maryam B. Echocardiographic evaluation of myocardial dysfunction in term neonates with perinatal asphyxia. Pak J Med Sci. 2024;40(9):2107-2111. doi: https://doi.org/10.12669/pjms.40.9.9501

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Muhammad Khalid, Nishtar Medical University & Hospital Multan

Senior Registrar

Pediatric Medicine

Iram Nawaz, Bakhtawar Amin Medical & Dental College

Senior Registrar

Department of Pediatric Medicine

Barera Maryam, Nishtar Medical University & Hospital Multan

Postgraduate Trainee

Department of Pediatric

Published
2024-09-25
How to Cite
Rasheed, J., Khalid, M., Nawaz, I., & Maryam, B. (2024). Echocardiographic evaluation of myocardial dysfunction in term neonates with perinatal asphyxia: Cardiac Dysfunction in Perinatal Asphyxia. Pakistan Journal of Medical Sciences, 40(9). https://doi.org/10.12669/pjms.40.9.9501
Section
Original Articles