Radiology & Medical Imaging Innovation Forum · 2026-10-15 · Pediatrics

ASSESSMENT OF CENTRAL NERVOUS SYSTEM STATUS IN NEWBORNS WITH PERINATAL ISCHEMIA

Maftuna A'zamovna Abdurakhimova
Department of Pediatrics and Neonatology No. 1, 6th-year student, Group 627, Faculty of Pediatrics, Samarkand State Medical University, Uzbekistan Scientific Supervisor: Kh. N. Sirojiddinova, PhD, Associate Professor

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Abstract

Background: Perinatal cerebral ischemia is an important cause of neurological disorders in newborns. Early assessment of clinical manifestations and identification of maternal and perinatal risk factors are essential for the timely detection of hypoxic brain injury. Objective: To investigate the clinical characteristics of newborns with cerebral ischemia during the neonatal period and to assess maternal obstetric history and perinatal factors associated with hypoxic injury. Materials and Methods: The study included 50 newborns who received inpatient or outpatient care at the Neonatology Department of the Regional Children's Multidisciplinary Medical Center in Samarkand, Uzbekistan, from 2022 to 2023. The newborns were divided into two groups: Group I included 15 infants with cerebral ischemia of hypoxic origin, and Group II included 35 infants with cerebral ischemia of non-hypoxic origin. Maternal obstetric history, antenatal and intrapartum factors, physical development, clinical status, and Apgar scores were evaluated. Results: Complicated pregnancies were reported in 53% of the mothers, while moderate-to-severe anemia and gestosis were reported in 30%. Ventriculomegaly was observed in 78% of newborns in Group I and was not reported in Group II. At the first minute of life, Apgar scores of 4–6 were recorded in 84% of infants in Group I and 30% in Group II. By the fifth minute, the corresponding proportions were 34% and 20%, respectively. Conclusion: Maternal anemia and adverse perinatal factors may be associated with hypoxic cerebral injury in newborns. Careful assessment of maternal risk factors and early neurological evaluation of newborns are important for identifying infants who require further monitoring and timely medical intervention.

Keywords: perinatal ischemia, cerebral ischemia, newborns, hypoxic brain injury, central nervous system, maternal anemia, Apgar score, ventriculomegaly, neonatal period.

The aim of the study was to investigate the clinical characteristics of newborns with cerebral ischemia during the neonatal period.

Materials and Methods

The study included 50 newborns who were hospitalized or received outpatient treatment at the Neonatology Department of the Regional Children's Multidisciplinary Medical Center in Samarkand from 2022 to 2023. All infants were divided into two groups: Group I consisted of 15 newborns with cerebral ischemia of hypoxic origin, while Group II included 35 newborns with cerebral ischemia of non-hypoxic origin.

The infants ranged in age from 5 to 28 days. Obstetric history and the peri- and postnatal development of both the newborns and their mothers were assessed. The evaluation included physical development, central nervous system (CNS) status, and overall clinical condition, based on objective physical examination findings. Morbidity during the first 28 days of life was also analyzed.

Among the newborns with cerebral ischemia of hypoxic origin in Group I, the reported proportion was 57%. Ventriculomegaly was observed in 78% of cases in this group, whereas no cases of this condition were reported in Group II.

Analysis of the maternal obstetric history revealed that anemia was a common finding among the mothers, whose mean age was 28 years. The mean number of pregnancies among mothers of infants with cerebral ischemia of hypoxic origin was 3.3, while the mean number of deliveries was 3. No statistically significant differences were found between the groups in the parameters analyzed. However, there was a trend toward higher maternal age and a greater number of pregnancies in Group I.

Analysis of the antenatal period showed that complicated pregnancies occurred in more than half of the mothers (53%). Anemia of moderate to severe degree and gestosis were reported in approximately one-third of the women (30%). No significant differences in antenatal pregnancy outcomes were identified between Groups I and II.

Analysis of the intrapartum period showed that approximately two-thirds of the mothers had full-term deliveries (68%). Nearly three-quarters of the newborns (74%) had a birth weight exceeding 2,500 g and a gestational age greater than 37 weeks. Preterm infants were present in both groups. No differences were identified between the groups in terms of delivery timing or gestational age at birth.

Among full-term infants with hypoxic CNS injury, the mean birth weight was 3,350.0 ± 580.4 g, whereas that of preterm infants was 2,030.0 ± 320.3 g. Their mean body lengths were 51.0 ± 3.5 cm and 46.0 ± 4.5 cm, respectively. No significant differences in anthropometric parameters were identified between the groups.

According to the Apgar score assessment, the overall mean score among the newborns was 6 at the first minute and 7 at the fifth minute. No differences between the study groups were reported in the mean Apgar scores.

At the first minute of life, signs of hypoxia, indicated by an Apgar score of 4–6, were significantly more frequent in Group I than in Group II, occurring in 84% and 30.0% of newborns, respectively. At the fifth minute, signs of hypoxia were observed in approximately similar proportions of infants in Groups I and II, at 34% and 20.0%, respectively.

Thus, pregnant women with anemia should be considered at increased risk of giving birth to infants with cerebral ischemia of hypoxic origin. These women require close monitoring by obstetricians and gynecologists to facilitate the early antenatal detection of hypoxic CNS injury in the fetus and enable timely preventive and therapeutic interventions. Particular attention should be paid to the early neonatal period, especially the first week of life.

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