Log in
Pediatrics · Chapter 13. Main syndromes requiring emergency care

Neonatal asphyxia

Asphyxia neonatorum

Neonatal asphyxia is a syndrome that occurs immediately at the time of birth and is caused by the development of acute hypoxia. The condition is accompanied by combined depression of the most vital body functions, primarily the nervous, respiratory, and cardiovascular systems.

Test your knowledge on this topicAsk the AI
Core conceptAcute hypoxia during labor leading to CNS, cardiac, and pulmonary dysfunction.
Key featureStrict time limit: intervention is required in the very first minutes of life.
Term infantsThe need for resuscitation arises in 0.5–2% of full-term newborns.
Preterm infantsThe risk of asphyxia reaches 80% or more with a birth weight of less than 1,000 grams.
2 min readFor medical studentsUpdated Sep 20, 2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Epidemiology and need for resuscitation

Primary resuscitation in the delivery room is directly aimed at reducing perinatal morbidity and mortality in infants. The leading cause of these adverse outcomes in the Russian Federation is precisely severe hypoxia (both antenatal and intranatal).

The probability that a child will require emergency care strongly correlates with gestational age and birth weight:

  • In full-term infants resuscitation measures are required relatively rarely: in 0.5–2% of cases.
  • Preterm and post-term infants are in the high-risk zone: 10–20%.
  • Infants with very low birth weight (VLBW, 1000–1500 g) require assistance in 25–50% of cases.
  • Infants with extremely low birth weight (ELBW, less than 1000 g) demonstrate the highest demand — from 50 to 80% and even higher.

Principles of care

The main challenge of neonatal resuscitation lies in the strict time limit. Physicians must restore the infant's vital functions in the very first minutes after delivery.

For this reason, there are two basic organizational rules:

  1. Universal preparedness. Equipment and specialists must be ready to perform resuscitation wherever delivery may occur, including the prehospital stage.
  2. Proactive approach. The neonatologist-resuscitologist must assess the maternal medical history and the course of labor in advance, identify risk factors, and predict the severity of the infant's condition even before birth.
Test your knowledge on this topicTasks from the "Pediatrics" course bank — immediate answers and explanations.

Antenatal risk factors

These are factors that affect the fetus even before the onset of regular contractions. They signal that the birth must be prepared for with particular care.

  • Maternal diseases: diabetes mellitus, hypertension, infectious diseases.
  • Pregnancy complications: preeclampsia (gestosis), late-term hemorrhage, rhesus incompatibility.
  • Fetal and environmental conditions: intrauterine growth restriction (IUGR), multiple pregnancy, abnormal amniotic fluid volume (polyhydramnios or oligohydramnios).
  • History: history of stillbirth in previous pregnancies.
  • Toxic exposure: maternal use of drugs, alcohol, or respiratory depressants.
  • Diagnostic findings: developmental anomalies on ultrasound, signs of fetal distress on cardiotocography (CTG).

Intrapartum risk factors

This group of causes arises directly during labor.

  • Timing: preterm (before 37 weeks) or post-term (after 42 weeks) labor.
  • Placenta and umbilical cord: placental abruption, placenta previa, umbilical cord prolapse (compression).
  • Labor progress: prolonged (over 24 hours) or precipitous labor, rupture of membranes exceeding 4 hours, abnormal fetal presentation.
  • Medical interventions: use of vacuum extractor or obstetric forceps, cesarean section, general anesthesia.
  • Signs of distress: fetal heart rate abnormalities, presence of meconium in amniotic fluid.
How to memorize

To memorize the groups of intrapartum factors, use the acronym "SPO-D" (Timing [Sroki], Placenta, Operations [Operatsii], Distress/Dynamics).

Something unclear? Ask the neural networkThe AI tutor has reviewed the material on "Neonatal asphyxia" and will explain it in simple terms.

What else to study on this topic

  • Apgar score assessment of the newborn
  • Primary resuscitation algorithm in the delivery room
  • CNS consequences of acute hypoxia
  • Resuscitation specifics for infants with extremely low birth weight
  • Prevention of antenatal and intrapartum hypoxia

Master the entire topic in the Pediatrics course

This is a summary. The course covers everything tested in classes and exams.

  • Complete study guide on "Neonatal asphyxia" and 3,738 more pages on the subject
  • Assignments and quizzes after every topic — just like in a colloquium
  • AI tutor answers questions on the topic anytime
  • 71 video lessons on the subject
Open full reviewSubject curriculumfrom 599 ₽ per month

Other topics in "Chapter 13. Main syndromes requiring emergency care"

Water-deficit dehydrationLaryngeal stenosisSalt-deficit dehydrationPale feverAnaphylactic shockDehydration in childrenComatose statesDiabetic comaHypoglycemic comaAcute adrenal insufficiencySeizure syndrome in childrenFebrile seizuresFever in childrenPoisoning in childrenEmergency care for poisoningCardiopulmonary resuscitation in childrenDefibrillation in childrenApgar ScoreNeonatal resuscitationCroup in ChildrenDifferential diagnosis of croupTreatment of croupPediatric anatomy and physiology
The entire section "Chapter 13. Main syndromes requiring emergency care"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.