Hypoxic-Ischemic Encephalopathy: About, Treatments, & Causes

While every mother hopes for a smooth delivery, complications do sometimes arise. Hypoxic-ischemic encephalopathy, or HIE, is a neonatal birth injury that occurs in two to nine out of every 1,000 live births.
You can break the injury down into its three components: hypoxia is a term for a shortage of oxygen in the blood, ischemia refers to a shortage of blood flow to the brain, and encephalopathy describes the brain damage that results from hypoxia and ischemia. Thus, hypoxic-ischemic encephalopathy is injury to the brain caused by a reduction in oxygen and blood flow. Lactic acid is released as cells begin to break down from the reduced circulation, which further disrupts normal cell function.
The prognosis of infants with HIE will ultimately depend on the extent of the oxygen deprivation.
Hypoxic-ischemic encephalopathy can be caused by any event that compromises blood and oxygen supply to the fetus. Causes and risk factors may include placental abruption, nuchal cords and other cord complications, uterine rupture, maternal hemorrhage, trauma, fetal bradycardia, prolonged labor, and labor and delivery errors.
HIE almost always increases an infant’s risk of developing cerebral palsy, intellectual disability, and motor or cognitive deficits. Therefore, once HIE has been diagnosed, aggressive intervention and treatment are key. As of right now, the only treatment available to reduce the extent of the physical damage caused by HIE is known as hypothermia therapy (or cooling). During hypothermia therapy, the baby is cooled down below homeostatic temperature (typically around 91° Fahrenheit) using a cooling cap or blanket. The cooling decreases the baby’s metabolic rate, which in turn stops the spread of brain damage and gives cells an opportunity to recover. Treatment typically lasts three days, and the baby is slowly warmed up after.
Hypothermia therapy can reduce or minimize disabilities, but it cannot completely reverse brain damage. Children with permanent disabilities from HIE typically turn to surgery, medication, therapy, and lifestyle supports to improve function and overall wellbeing.
Learn more about hypoxic-ischemic encephalopathy at the HIE Help Center. Find the knowledge, resources, and support you need to move life forward for you and your baby.