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Hypoxic ischemic encephalopathy (HIE) is injury to the brain because of a lack of oxygen. The injury can lead to a range of disabilities. A severe injury can lead to death.
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Brain cells can start to die after 4 minutes without oxygen. This may happen because of poor blood flow to brain or low levels of oxygen in the blood. In a newborn, it is often caused by a problem at birth. Some HIE in newborns may be caused by a disease or illness.
Factors before or during labor and delivery that increase the risk of HIE include:
Symptoms can vary from mild to severe. They may include:
Some symptoms such as learning or development delays may not appear until the child is older.
Baby's are observed after birth. An APGAR score will check signs of health. A baby with HIE will have lower APGAR scores. An MRI scan may be done. This will help to show or track damaged areas of the brain. The doctor will use these results as well as details about the birth to diagnose HIE.
Other tests may be needed if a cause is not clear. This may include blood tests.
Immediate care will make sure the brain is getting enough oxygen. Support may include:
The long term effects of HIE will depend on the area of the brain and amount of damage. Some may have severe disabilities. Others may be mild and not apparent until the baby is older. Early intervention is important. Supportive care will help to minimize the effect of the injury. Assistive devices, exercises, and learning aids may be needed.
In most cases, HIE is sudden and cannot be prevented.
Family Doctor—American Academy of Family Physicians
Healthy Children—American Academy of Pediatrics
About Kids Health—The Hospital for Sick Children
Douglas-Escobar M, Weiss MD. Hypoxic-ischemic encephalopathy: a review for the clinician. JAMA Pediatr. 2015 Apr;169(4):397-403.
Hypoxic ischemic encephalopathy of the newborn. London Health Sciences Centre website. Available at: http://www.lhsc.on.ca/Patients_Families_Visitors/Childrens_Hospital/Programs_and_services/Neurology/HIE.pdf. Updated January 2010. Accessed January 11, 2019.
Hypoxic-ischemic encephalopathy. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Updated February 23, 2018. Accessed January 11, 2019.
Neonatal hypoxic-ischemic encephalopathy (HIE). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116449/Neonatal-hypoxic-ischemic-encephalopathy-HIE. Updated July 30, 2018. Accessed January 11, 2019.
Last reviewed August 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 1/8/2019