Asphyxia Neonatorum | Definition & Patient Education

Asphyxia Neonatorum

What is asphyxia neonatorum?

Asphyxia neonatorum is a condition that occurs when a baby doesn’t get enough oxygen during the birth process. It can be fatal. Other names for it are perinatal asphyxia, hypoxic-ischemic encephalopathy, and birth asphyxia.

What are the symptoms of asphyxia neonatorum?


Babies may not experience the symptoms of asphyxia neonatorum right away. A fetal heart rate that’s too high or low can be an indicator.

Your baby may experience immediate symptoms after birth. These can include:

  • skin that appears pale or blue
  • difficulty breathing, which may cause symptoms such as nasal flaring or abdominal breathing
  • a slow heart rate
  • weak muscle tone

The length of time your baby goes without oxygen affects the severity of symptoms. The longer a baby is without oxygen, the more likely they are to experience symptoms. More severe symptoms can include injury or failure of the:

  • lungs
  • heart
  • brain
  • kidneys

What are the causes of asphyxia neonatorum?


Anything that affects your baby’s ability to take in oxygen can cause asphyxia neonatorum. During labor and delivery, doctors must carefully manage oxygen levels for both mother and baby to reduce risks.

Asphyxia neonatorum can occur if one or more of the following occurs:

  • Your baby’s airway is blocked.
  • Your baby has anemia, which means their blood cells don’t carry enough oxygen.
  • The delivery lasts too long or is difficult.
  • The mother doesn’t get enough oxygen before or during delivery.
  • The mother’s blood pressure is too high or low during delivery.
  • An infection affects the mother or the baby.
  • The placenta separates from the uterus too quickly, resulting in a loss of oxygen.
  • The umbilical cord wraps improperly around the baby.

There are two ways babies who lose oxygen before, during, or after delivery can experience asphyxia neonatorum. The lack of oxygen can cause immediate damage. This can happen within minutes. Damage can also occur when cells recover from the lack of oxygen and release toxins into the body.

Who is at risk for asphyxia neonatorum?

Risk Factors

According to the Seattle Children’s Hospital, asphyxia neonatorum occurs in about 4 out of every 1,000 live births in the United States. Premature babies are at increased risk for this condition. Babies born to mothers with conditions that affect pregnancy, such as diabetes mellitus or preeclampsia, are also at greater risk. A study published in the Italian Journal of Pediatrics notes that the mother’s age or the baby’s low birth weight are also risk factors. It’s also more common in developing countries where mothers have less access to proper prenatal and postnatal care.

How is asphyxia neonatorum diagnosed?


Your baby will receive an Apgar score about 1 to 5 minutes after birth. The scoring system has five factors:

  • breathing
  • pulse
  • appearance
  • response to stimulus
  • muscle tone

Each factor gets a score of 0, 1, or 2. The highest score possible is 10. A baby with a lower Apgar score has a higher risk for asphyxia neonatorum. A score lower than 7 can indicate that a baby doesn’t have enough oxygen. The doctor may suspect your baby has asphyxia neonatorum if they have an Apgar score of 3 or lower for more than 5 minutes.

A doctor may also test a baby’s blood for high acid levels. This can indicate poor oxygenation. A doctor may also order blood tests to see if a baby’s kidneys, heart, and liver might be affected.

How is asphyxia neonatorum treated?


The severity of your baby’s symptoms influences the treatment. The timing of when your baby receives the diagnosis also affects their treatment. For example, mothers may receive additional oxygen before delivery to boost a baby’s oxygenation before birth. A cesarean delivery is a potential treatment in prolonged or difficult deliveries.

After birth, babies with the condition may need ventilation to support their breathing. Keeping babies warm has also been shown to reduce harmful effects. Doctors will also monitor the baby’s blood pressure and fluid intake to make sure they’re getting enough oxygen.

Some babies can experience seizures as a result of asphyxia neonatorum. Doctors should carefully treat these babies to avoid injury from seizures. The following may help the baby:

  • anti-inflammatory medications
  • magnesium
  • vitamins
  • allopurinol, which is a medication that reduces acid buildup in the body

What is the long-term outlook?


The outlook depends on how long your baby goes without oxygen. Surviving babies can experience anything from no consequences to major long-term disabilities.

Asphyxia neonatorum is a leading cause of brain damage and death in infants worldwide. An estimated 900,000 babies die each year around the world due to asphyxia neonatorum, according to the World Health Organization, the majority of these deaths occur in developing countries. Early diagnosis and prompt treatment of the condition are vital to saving the baby and minimizing complications.

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