All About Birth Asphyxia: What to Know and How it's Addressed

Asphyxia refers to insufficient oxygen supply for the baby before, during, or immediately after their birth. If a baby does not receive enough oxygen before, during, or after birth, they are said to suffer from birth asphyxia. This condition is also referred to as neonatal asphyxia and perinatal asphyxia.

What Are the Symptoms of Birth Asphyxia?

A baby with this medical condition usually has:

• No breathing or is breathing too weakly
• Bluish or pale skin
• Low heart rate
• Poor muscle tone or weak reflexes
• High blood acidity
• Meconium in the amniotic fluid
• Seizures

What Are the Causes of Birth Asphyxia?

Common causes of neonatal asphyxia include:

• Low oxygen levels in the maternal blood due to respiratory or heart problems, or low respiration due to the effect of anesthesia
• Placental abruption, a condition in which the placenta gets separated from the uterus earlier than normal
• Insufficient relaxation of the uterus during labor that abrupts the smooth circulation of oxygen to the placenta
• High blood pressure, along with poor placental function, or post-term pregnancies that have gone beyond 42 weeks
• The blocked airway of your baby
• Anemia in your baby, a condition that impedes his/her blood cells from carrying sufficient oxygen
• Difficult and/or prolonged labor
• Problems with the umbilical cord
• Maternal or neonatal infections
• Maternal high or low birth pressure
• Low maternal blood pressure and compression of the umbilical cord
• Breathing disorders in the baby
• Neonatal anemia
• Factors that may lower the level of oxygen after the birth of your baby

Some factors that may reduce oxygen levels in the baby after birth are:

• Low blood pressure
• Heart disease
• Severe anemia or low blood cell count, which affects the blood’s ability to carry sufficient oxygen
• Shock
• Respiratory problems that limit oxygen intake
• Lung disease

How to Diagnose Birth Asphyxia?

Your doctor may recommend tests related to the following to diagnose the root cause of this medical condition in your baby:

• Severe blood acid levels – pH less than 7.00 – in the arterial blood of the umbilical cord usually indicates this medical condition
• Apgar score between 0 and 3 for more than five minutes probably indicates birth asphyxia. This test analyzes your baby’s heartbeat, respiration, reflexes, and muscle tone after birth
• Neurological problems like poor muscle tone and seizures
• Medical conditions in your baby like conditions of respiratory and digestive systems

How to Treat This Medical Condition?

Babies with mild asphyxia only need breathing support and close supervision. A more serious condition of birth asphyxia may require a breathing machine, respiratory therapy, and medication. A delay in feeding is also necessary for the bowel to recover.

Advanced treatment options include:

• High-frequency breathing assistance with gentle puffs of air sent to the baby’s lungs to avoid possible damage caused by conventional breathing machines;
• Nitric oxide inhalation to treat respiratory failure and pulmonary hypertension. Nitric oxide is administered directly into the windpipe to help with the dilation of blood vessels in the lungs, allowing oxygenated blood to circulate in the body
• Hypothermia started within six hours after birth to reduce brain damage;
• Extracorporeal membrane oxygenation (ECMO) to support the baby’s heart and lungs, if they are not functioning properly.

How This Medical Condition Affects the Baby?

Four out of 1,000 full-term babies suffer perinatal asphyxia. Babies who are born prematurely are more likely to suffer from the condition. The extent of damage caused by this medical condition depends on how long and how severe the lack of oxygen is, and how soon the baby receives proper treatment.

Within minutes of asphyxia, the lack of blood and oxygen supply results in cell damage. After the restoration of the blood and oxygen supply to the brain, reperfusion injury occurs due to the release of toxins from the damaged cells.

While mild and moderate asphyxia does not leave permanent damage, prolonged and severe asphyxia may cause long-lasting injury to the baby’s brain, heart, and other vital organs. Asphyxia in premature babies is likely to result in cerebral palsy, developmental problems, attention deficit hyperactivity disorder, or impaired vision. Severe asphyxia may lead to organ failure and death.

Consult your doctor for any concerns.

Learn more about Giving Birth and Complications here.