Pediatric Hypoxic-ischemic Encephalopathy (HIE)

Pediatric Hypoxic-ischemic Encephalopathy (HIE)



Hypoxic-ischemic encephalopathy (HIE) happens when a baby's brain does not receive enough oxygen during birth.

Expanded overview

Hypoxic-ischemic encephalopathy (HIE) is a brain injury that occurs when a baby’s brain does not receive enough oxygen during birth. The condition is also sometimes called intrapartum asphyxia. It is the most common cause of severe brain injury and death in newborns.

Babies who have hypoxic-ischemic encephalopathy may experience life-long problems, such as:

  • Cognitive disorders
  • Developmental delay
  • Neurological problems
  • Problems with motor development

Hypoxic-ischemic encephalopathy may be mild, moderate or severe. The amount and type of brain damage depends on how long the baby is without oxygen. 


There are several reasons a baby may be deprived of oxygen during birth, including:

  • Excessive pressure on the baby’s cranium during birth
  • Fetal stroke
  • Heart problem
  • Hemorrhage during birth (mother)
  • Injury during birth
  • Low blood oxygen level in baby
  • Placental abruption (separation of the placenta from the uterus)
  • Sudden drop in the mother’s blood pressure (acute hypotension)
  • Umbilical cord complication, such as prolapse
  • Uterine rupture
  • Vasa previa (fetal umbilical tissue) rupture


The signs of hypoxic-ischemic encephalopathy are not always seen right away. Parents and doctors may notice delayed development and neurological problems as the child grows.
Some symptoms that may be seen immediately after birth include:

  • Heart problems
  • Kidney problems
  • Liver problems
  • Lung problems
  • Organ failure
  • Seizures

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