Birth Asphyxia and its manifestations

Last modified: Friday, July 15, 2016
Definition: Birth asphyxia Birth asphyxia is defined as a reduction of oxygen delivery and an accumulation of carbon dioxide owing to cessation of blood supply to the fetus around the time of birth.

Although , APGAR score is retrospective scoring , it has been used to assess the severity of Asphyxia.
  1. Apgar score 8~10: no asphyxia
  2. Apgar score 4~8: mild
  3. Apgar score 0~3: severe



Respiratory system: MAS, RDS, pulmonary hemorrhage

CVS: heart failure, cardiogenic shock

Gastrointestinal system: NEC, stress gastric ulcer

Others: hypoglycemia, hypocalcemia, hyponatremia


American Academy of Pediatrics (AAP) and the American College of Obstetrics and Gynecology (ACOG) suggest that all of the following must be present for the designation of perinatal asphyxia severe enough to result in HIE:

1. Profound metabolic or mixed acidemia (pH < 7) in an umbilical artery blood sample, if obtained
2. Persistence of an Apgar score of 0-3 for longer than 5 minutes 
3. Neonatal neurologic sequelae (eg, seizures, coma, hypotonia) 
4. Multiple organ involvement (eg, kidney, lungs, liver, heart, intestines)

Suggested reading: Thompson Scoring for HIE

Here is the details for MBBS students on HIE- A CNS manifestation of Asphyxia

Hypoxic ischemic encephalopathy: Lecture on HIE from Sujit Shrestha

Any confusions can be cleared from author through comments. Feedback are welcomed.



  1. so am trying to write a case write-up of a 5 day old baby with APGAR score of 3/10 at 1 min then 7/10 at 5 mins and then 7/10 at 10 mins,in that case the baby should be considered to have had perinatal asphyxia?


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