Birth asphyxia happens when infants don’t get enough oxygen around the time they are born. It’s a serious medical event that can cause brain injury, disability, and death.

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Birth asphyxia, also known as perinatal asphyxia, happens when a baby doesn’t get enough oxygen before, during, or right after birth. Many babies experience limited levels of reduced oxygen after birth, and this usually isn’t a problem. But when the lack of oxygen is severe and long lasting, it can have harmful effects on an infant.

Let’s take a look at what birth asphyxia is, what the signs are, how it’s diagnosed and treated, the outlook, and what can be done to prevent it.

The World Health Organization (WHO) describes birth asphyxia as the failure to establish breathing at birth and notes that it accounts for about 900,000 infant deaths around the world each year.

Birth asphyxia usually refers to any instance of oxygen deprivation or inadequate blood flow to vital organs that happen during or close to the time of childbirth. When asphyxia is severe or sustained, it usually first causes damage to the brain and then can damage organs such as the lungs, heart, and kidneys.

Lack of oxygen at birth can cause mild to severe symptoms in infants. Some potential signs and symptoms may include:

  • breathing issues and respiratory distress
  • signs of hypoxia, such as turning blue or grayish
  • at first, infants may have trouble settling and being wakeful
  • later, infants may be lethargic and exhibit low muscle tone (hypotonia)
  • infants may have decreased muscle reflexes (hyporeflexia)
  • seizures may occur in severe cases

There are various conditions or circumstances that can cause birth asphyxia. These can occur during pregnancy, during childbirth, or post-birth.

Some of the causes of birth asphyxia include:

  • heart and respiratory issues in a birthing parent, resulting in a lack of oxygen to the infant
  • problems with the uterus, such as uterine rupture
  • problems with the placenta, such as placenta abruption
  • umbilical cord issues, including cord knotting, cord compression, cord prolapse
  • infection in the birthing person
  • a birthing person deprived of oxygen for any reason
  • hemorrhaging during childbirth

The complications birth asphyxia can cause depend on how severe the lack of oxygen is and how long it lasts.

Birth asphyxia has several stages. First, it can affect an infant’s brain. Then, it can cause damage to organs. Though less common, severe birth asphyxia can result in infant death.

Babies who survive birth asphyxia may face disabilities, and the condition is a top cause of brain injury in newborns. Birth asphyxia can cause the following conditions:

The treatment for birth asphyxia will depend on when and how the condition is presenting. Some strategies medical providers use to treat birth asphyxia include:

  • treating any conditions in the birthing parent that are contributing, such as providing oxygen to a parent who is oxygen deprived
  • infants with signs of oxygen deprivation may need oxygen supplementation, breathing support, or intubation
  • infants may also need medication for blood pressure issues and dialysis for kidney failure
  • therapeutic hypothermia, which means cooling of the body, is performed in the hours and days after birth asphyxia and is considered an effective technique to prevent further damage

Birth asphyxia is a serious condition that may result in severe complications and death. The condition is more common in underdeveloped countries with less advanced medical care, but it affects infants in more developed countries as well.

In developed countries, birth asphyxia impacts roughly 2 out of every 1,000 births. In developing countries, the rate can be as much as 10 times as high. Severe birth asphyxia can lead to infant death about 15–20% of the time. About 25% of infants are left with neurological injury.

The following criteria may be used to diagnose birth asphyxia in newborns:

  • signs of brain or neurological damage, such as weak muscle tone, a weak suck, breathing issues, and seizures
  • signs of organ failure
  • high acid levels (a pH less than 7) in the infant’s blood or umbilical cord
  • an APGAR score of five or less 10 minutes after birth, along with a prolonged requirement for resuscitation

Not all instances of birth asphyxia can be prevented, but in countries with more thorough prenatal care and advanced medical care, rates of birth asphyxia are lower. Advanced medical care can treat many of the complications that happen at delivery that can lead to birth asphyxia, such as hemorrhaging and umbilical cord issues.

Certain risk factors increase the chances of birth asphyxia, and some of these risk factors are modifiable, which can prevent the occurrence of birth asphyxia. Preventable or controllable risk factors include:

When is birth asphyxia most likely to occur?

The majority of the time, events that cause birth asphyxia occur during labor and delivery.

How effective is therapeutic hypothermia?

Therapeutic hypothermia, also known as whole body cooling, can decrease the chances of death or serious disability. When begun within 6 hours of birth, it decreases severe outcomes from about 62–48%.

When do most deaths from birth asphyxia happen?

Most deaths from birth asphyxia — 98% — will happen in the first week after birth. Of those deaths, 75% happen in the first day after birth, while only 2% of them happen after 72 hours of life.

It’s common for babies to experience limited moments of oxygen deprivation after birth, and this is usually nothing to worry about. However, when the deprivation is severe and long lasting, brain injury, organ failure, and even death can occur.

If you have further questions about birth asphyxia and how you can reduce the risk of it happening to your baby, please speak with a healthcare professional.