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Study Claims Most Birth Asphyxia Cases Preventable

December 4, 2013

Birth asphyxia, also known as birth hypoxia, or intrauterine hypoxia, occurs when a newborn is deprived of oxygen. This complication can lead to permanent brain damage and even death of the infant. In cases of brain damage, we typically see children diagnosed with cerebral palsy and neural tube defects. Babies who experience birth asphyxia are also at higher risk for sudden infant death syndrome (SIDS).

A recent study conducted and published in Norway suggests that about half of the instances of birth asphyxia in that country are preventable. These findings are especially troubling since Norway is known for its effective and inexpensive healthcare system.

Researchers collected data from the Norwegian System of Compensation to Patients (NPE) spanning from 1994 — 2008, examining and analyzing “hospital records, experts’ assessments and the decisions made by the NPE, the appeal body and courts of law.” A total 305,161 cases ended in financial compensation for victims’ families, and of these 161 cases, 107 children survived while 54 died. The number one reason cited for this substandard care (present in a full 50 percent of cases) was human error, defined in this study as “inadequate fetal monitoring.”

The second- and third-most common reasons for birth asphyxia were “lack of clinical knowledge and skills” (14 percent) and “noncompliance with clinical guidelines” (11 percent). Other mistakes were “failure in referral for senior medical help” and “error in drug administration” (at 10 percent and 4 percent respectively). About 49 percent of obstetricians were held responsible for substandard care, compared with midwives, who were held accountable in 46 percent of cases.

Birth asphyxia is all-too-often a preventable tragedy. Potential causes are cord prolapse (when the umbilical cord leaves the uterus before the baby), cord occlusion, placental infarction (growth of extra tissue or lesions on the placenta), or a nuchal cord (when the umbilical cord wraps around the newborn’s neck). It may also result from excessive maternal sedation by anesthesia, abruption of the placenta, breech delivery (also known as breech birth–when the child comes out of the uterus foot-first rather than head-first), or prolonged labor.

Researchers concluded, “Substandard care is common in birth asphyxia, and human error is the cause in most cases. Inadequate fetal monitoring and lack of clinical knowledge and skills are the most frequent reasons for compensation after birth asphyxia.” These findings suggest that more effective training is necessary in the obstetric field. Researchers imply, however obvious it may sound, that simply paying closer attention to newborns at risk for asphyxia may reduce its too-frequent occurrence.

As mentioned above, though this study was conducted in Norway, birth asphyxia remains a problem in the United States as well. Hospital Review reports that it is the ninth most expensive condition treated in American hospitals and that it may be a contributing factor to cardiac and circulatory birth defects, which cost Americans even more in hospital bills each year.

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