Death#
Executive summary
Outcome: Perinatal death
Specific to HIE?
No
Which infants with HIE?
Most severe HIE
Any other benefits or caveats not already mentioned?
Death is the outcome, but it is not an outcome that helps us distinguish anything - we’d need to know cause of death, and in that case, it’s based on other information in the record, and not on whether or not they died.
Conclusion: Not recommended. Death is an outcome that can result from HIE - however, it doesn’t help us identify whether or not an infant had HIE.
Causes of perinatal morality#
The MBRRACE-UK Perinatal Mortality Surveillance Report on UK perinatal deaths for births in the UK in 2021 provides extensive information on the causes of perinatal death.
Causes of stillbirths:
33.2% placental causes
9.3% due to congenital anomalies
4.7% cord-related causes
4.5% due to infection
33.3% unknown cause
Causes of neonatal deaths:
32.6% due to congenital anomalies
14.2% due to extreme prematurity
14.0% due to neurological causes
9% due to cardio-respiratory causes
7.7% due to infection
Neonatal deaths attributed to intrapartum causes remain low at 2.2% (a rate of 0.04 per 1,000 live births in 2021). However, an additional 11.1% of neonatal deaths of babies born from 32 weeks’ gestational age (0.18 per 1,000 live births) were attributed to Hypoxic Ischemic Encephalopathy (HIE), a type of brain injury caused by lack of oxygen to the baby’s brain around the time of birth.
Association between HIE and death#
Not all infants with HIE will die. In the US, the overall mortality rate of HIE is 15% to 25% with 40% to 50% of survivors developing long-term neurologic disabilities.[Acun et al. 2022]