Skip to Main Content




Each year, an estimated 23% of the 3.5 million neonatal deaths that occur worldwide are the result of birth asphyxia. In the United States, preliminary 3.9 million children are born annually, with a reported infant mortality rate of 6.11 for the year 2011.1,2 This suggests that every year, among US children who reach 28 weeks’ gestation, over 26,000 die prior to their seventh day of life. A significant portion of those infants who succumb do so from birth asphyxia. Further, among children reaching term gestation, 2 to 3 per 1000 live term births suffer hypoxic ischemic encephalopathy (HIE), (0.3 per 1000 severe HIE). (Table 24-1) Up to 80% of infants who survive severe hypoxic-ischemic encephalopathy develop serious complications and 10% to 20% develop moderately serious disabilities. In addition, it is widely accepted that 10% of all newborns require some assistance to begin and maintain normal breathing and that 1% require aggressive resuscitation. Thus, using the national birth rate data, annually 400,000 newborns need some help during the perinatal period, 40,000 per year require expert assistance to reverse profound cardiorespiratory depression, and 1200 per year develop severe HIE. Although there is some evidence that therapeutic hypothermia is beneficial to term newborns with moderate to severe hypoxic ischemic encephalopathy, and that cooling decreases death without increasing major disability in survivors, this therapy is not available at all centers yet as further research is being compiled. (Table 24-2).

Table Graphic Jump Location
TABLE 24-1.ACOG and American Academy of Pediatrics (AAP) Task Force on Neonatal Encephalopathy and Cerebral Palsy
Table Graphic Jump Location
TABLE 24-2.Criteria for Hypothermia Therapy

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.