Echocardiographic evaluation of myocardial dysfunction in term neonates with perinatal asphyxia.

Background & Objective: One third of the neonatal deaths worldwide are attributed to perinatal asphyxia. We aimed to determine the prevalence and determinants of cardiac dysfunction, through echocardiographic evaluation, in term neonates with perinatal asphyxia. Methods: This cross-sectional study was conducted at a tertiary care setting over a period of six months from 1 Results: Among 166 neonates, 53% (n=88) were males, mean gestational age was 38.1 ± 0.89 weeks. Moderate asphyxia was present in 121 (72.9%). Most common echocardiographic finding was pulmonary hypertension in 50% followed by patent ductus arteriosus (PDA) in 37.2% and mitral regurgitation in 6.6%. Myocardial dysfunction was detected in 28.9% of the neonates. Three independent determinants of myocardial dysfunction were severe asphyxia [adjusted odds ratio (aOR) 5.01, 95% CI 2.2-11.4; p-value <0.001], having patent ductus arteriosus (aOR 5.11, 95% CI 2.2-11.8; p-value < 0.001) and delivery through cesarean section (aOR 2.65, 95% CI 1.2-5.9; p-value 0.02). Conclusions: Myocardial dysfunction among neonates with perinatal asphyxia is common and severity of asphyxia, mode of delivery and presence of patent ductus arteriosus are important determinants.