{"id":{"repo_id":"edinburgh","oai_identifier":"oai:era.ed.ac.uk:1842/29120"},"canonical_url":"https://search.dev.ndltd.org/etd/edinburgh/oai:era.ed.ac.uk:1842/29120","repository":{"repo_id":"edinburgh","name":"University of Edinburgh","base_url":"https://era.ed.ac.uk/server/oai/request"},"display":{"title":"Epidemiological and pathological correlates of early neonatal mortality","abstract":"INTRODUCTION Despite improved intrapartum monitoring of the fetus, the rate of cerebral palsy has not decreased. Many studies now suggest that the majority of children with such disability may sustain damage in utero. Current understanding and identification of antenatal brain injury is poor and individual vulnerability may be important. Specific genotypes such as Apolipoprotein E are disadvantageous to outcome in the context of adult brain injury and may also be important in early development.","abstract_html":"INTRODUCTION Despite improved intrapartum monitoring of the fetus, the rate of cerebral palsy has not decreased. Many studies now suggest that the majority of children with such disability may sustain damage in utero. Current understanding and identification of antenatal brain injury is poor and individual vulnerability may be important. Specific genotypes such as Apolipoprotein E are disadvantageous to outcome in the context of adult brain injury and may also be important in early development.","abstract_has_math":false,"creators":["Becher, Julie-Clare"],"institution":"The University of Edinburgh","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2006,"date_issued":"2006","date_published":"2006","updated_at":"2026-07-24T02:14:03Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/1842/29120","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Becher, Julie-Clare"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2018-03-29T12:16:38Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2018-03-29T12:16:38Z"]},{"key":"dc:date.issued","label":"Date","values":["2006"]},{"key":"dc:publisher","label":"Institution","values":["The University of Edinburgh"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["Already catalogued"]},{"key":"dc:type","label":"Dc Type","values":["Thesis or Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["MD Doctor of Medicine"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/1842/29120"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["INTRODUCTION Despite improved intrapartum monitoring of the fetus, the rate of cerebral palsy has not decreased. Many studies now suggest that the majority of children with such disability may sustain damage in utero. Current understanding and identification of antenatal brain injury is poor and individual vulnerability may be important. Specific genotypes such as Apolipoprotein E are disadvantageous to outcome in the context of adult brain injury and may also be important in early development.","OBJECTIVES An aim of this project was to identify clinical and genetic risk factors for early neonatal mortality within the Scottish population with special consideration for those infants born in an asphyxiated condition. A further aim was to determine the prevalence of antenatal brain injury within this population and to correlate neuropathology with clinical factors.","METHODS Clinical data and neuropathological specimens were collected as part of the Scottish National Perinatal Neuropathology Study from all 22 delivery units throughout Scotland. Birth asphyxia was defined and infants were classified accordingly. Neuropathological examination was performed by a single observer in Edinburgh who was blind to clinical detail. Apolipoprotein E genotype was analysed and compared with known published data for adults and healthy newborns. Comparisons of categorical data were made with the Chi-square test and numerical data were compared using the unpaired student's t-test or the Mann Whitney U test.","RESULTS Clinical data was collected from 191 early neonatal deaths. Complications of pregnancy were common in all neonatal deaths. The only predictive factors for asphyxia were indicators of intrapartum fetal distress. Neuropathological examination was possible in 59 infants surviving 3 days or less. Evidence of prelabour brain injury was observed in nearly half of this cohort, and this was significantly more common in asphyxiated infants and those who developed an encephalopathy. The only clinical associations of such damage were the presence of cardiotocograph abnormalities, meconium staining and severe depression at birth. Apolipoprotein E analysis was performed in 252 perinatal deaths. There was an over representation of the s4 allele among healthy newborns compared to perinatal deaths and adults.","CONCLUSIONS Brain injury occurring in utero is a common finding among neonatal deaths, particularly in those born with asphyxia. Current intrapartum indicators of fetal distress may signify a fetus who has already suffered compromise prior to the onset of labour. Differences in the Apolipoprotein s4 genotype in perinatal populations suggest that the fetus may vary in its ability to withstand fatal injury."]},{"key":"dc:title","label":"Title","values":["Epidemiological and pathological correlates of early neonatal mortality"]}]}],"canonical_facts":{"dc:creator":["Becher, Julie-Clare"],"dc:date.accessioned":["2018-03-29T12:16:38Z"],"dc:date.available":["2018-03-29T12:16:38Z"],"dc:date.issued":["2006"],"dc:description.abstract":["INTRODUCTION Despite improved intrapartum monitoring of the fetus, the rate of cerebral palsy has not decreased. Many studies now suggest that the majority of children with such disability may sustain damage in utero. Current understanding and identification of antenatal brain injury is poor and individual vulnerability may be important. Specific genotypes such as Apolipoprotein E are disadvantageous to outcome in the context of adult brain injury and may also be important in early development.","OBJECTIVES An aim of this project was to identify clinical and genetic risk factors for early neonatal mortality within the Scottish population with special consideration for those infants born in an asphyxiated condition. A further aim was to determine the prevalence of antenatal brain injury within this population and to correlate neuropathology with clinical factors.","METHODS Clinical data and neuropathological specimens were collected as part of the Scottish National Perinatal Neuropathology Study from all 22 delivery units throughout Scotland. Birth asphyxia was defined and infants were classified accordingly. Neuropathological examination was performed by a single observer in Edinburgh who was blind to clinical detail. Apolipoprotein E genotype was analysed and compared with known published data for adults and healthy newborns. Comparisons of categorical data were made with the Chi-square test and numerical data were compared using the unpaired student's t-test or the Mann Whitney U test.","RESULTS Clinical data was collected from 191 early neonatal deaths. Complications of pregnancy were common in all neonatal deaths. The only predictive factors for asphyxia were indicators of intrapartum fetal distress. Neuropathological examination was possible in 59 infants surviving 3 days or less. Evidence of prelabour brain injury was observed in nearly half of this cohort, and this was significantly more common in asphyxiated infants and those who developed an encephalopathy. The only clinical associations of such damage were the presence of cardiotocograph abnormalities, meconium staining and severe depression at birth. Apolipoprotein E analysis was performed in 252 perinatal deaths. There was an over representation of the s4 allele among healthy newborns compared to perinatal deaths and adults.","CONCLUSIONS Brain injury occurring in utero is a common finding among neonatal deaths, particularly in those born with asphyxia. Current intrapartum indicators of fetal distress may signify a fetus who has already suffered compromise prior to the onset of labour. Differences in the Apolipoprotein s4 genotype in perinatal populations suggest that the fetus may vary in its ability to withstand fatal injury."],"dc:identifier.uri":["http://hdl.handle.net/1842/29120"],"dc:publisher":["The University of Edinburgh"],"dc:relation.isreferencedby":["Already catalogued"],"dc:title":["Epidemiological and pathological correlates of early neonatal mortality"],"dc:type":["Thesis or Dissertation"],"dc:type.qualificationlevel":["Doctoral"],"dc:type.qualificationname":["MD Doctor of Medicine"]},"updated_at":"2026-07-24T02:14:03Z"}