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Asphyxia in liveborn infant

Last edited: 4/14/2026

Overview

Asphyxia in liveborn infants refers to a condition where a newborn experiences insufficient oxygen supply around the time of birth, potentially leading to severe morbidity or mortality. This condition can result from various factors including placental abruption, cord complications, and respiratory distress. 2936

Diagnosis

  • Clinical signs include central cyanosis, apnea, bradycardia, or hypoxia post-birth.
  • Diagnostic tests may include umbilical cord assessment, immediate Apgar scores, and neonatal blood gas analysis.
  • Post-mortem imaging and placental pathology can provide additional insights into causative factors 210.

    • Management

  • Immediate resuscitation efforts including positive pressure ventilation, chest compressions, and oxygen supplementation.
  • Monitoring and supportive care in neonatal intensive care units (NICU) for prolonged periods if necessary.
  • Early identification and management of underlying causes such as cord prolapse or placental issues 2936.

    • Special Populations

  • Pregnancy: Enhanced surveillance for risk factors like decreased fetal movements, which may precede asphyxia 13.
  • Comorbidities: Women with history of stillbirths or placental issues may require closer monitoring and specialized care 111.

    • Key Recommendations

  • Implement continuous fetal monitoring during labor to detect signs of fetal compromise early (Evidence: Moderate 29).
  • Provide skilled birth attendance and ensure availability of emergency obstetric care to mitigate intrapartum stillbirths (Evidence: Moderate 34).
  • Offer bereavement support and psychological counseling to families experiencing stillbirth or neonatal asphyxia (Evidence: Expert opinion 111).
  • Conduct thorough post-mortem investigations and placental examinations to identify potential causes of asphyxia (Evidence: Moderate 1011).
  • Educate healthcare providers on effective communication strategies when delivering news of neonatal complications (Evidence: Moderate 1722).

    • References

    1 Roush K. Stillbirths Occur in the U.S. More Often Than Reported. The American journal of nursing 2026. link 2 Loughnan SA, Wojcieszek AM, Singline L, Griffin A, Boyle FM, Ellwood D et al.. Post-Mortem Imaging to Investigate the Causes of Stillbirth in Australia: Views of Parents, Midwives and Obstetricians. Journal of medical imaging and radiation oncology 2025. link 3 Mukherjee A, Di Stefano L, Blencowe H, Mee P. Determinants of stillbirths in sub-Saharan Africa: A systematic review. BJOG : an international journal of obstetrics and gynaecology 2024. link 4 Goldenberg RL, Saleem S, Aziz A, McClure EM. International progress on stillbirth reduction: Changes in Stillbirth Rates in Selected Low and Middle-Income Countries from 2000 to 2021. Seminars in perinatology 2024. link 5 Gold KJ, Boggs ME, Plegue MA. Gaps in Stillbirth Bereavement Care: A Cross-Sectional Survey of U.S. Hospitals by Birth Volume. Maternal and child health journal 2024. link 6 Escañuela Sánchez T, O Donoghue K, Byrne M, Meaney S, Matvienko-Sikar K. A systematic review of behaviour change techniques used in the context of stillbirth prevention. Women and birth : journal of the Australian College of Midwives 2023. link 7 Ibitayo K. Never Tell a Mother. Nursing for women's health 2023. link 8 Khatlani K, Azam I, Baqir M, Mehmood A, Pasha-Razzak O. Exploring the relationship between intimate partner violence during pregnancy and stillbirths. Injury 2023. link 9 Ssegujja E, Ddumba I, Andipatin M. An exploration of health workers' experiences in providing bereavement care to mothers following a stillbirth: results from a subnational level health system in Uganda. BMC pregnancy and childbirth 2023. link 10 Leduc L. No. 394-Stillbirth Investigation. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2020. link 11 Kc A, Berkelhamer S, Gurung R, Hong Z, Wang H, Sunny AK et al.. The burden of and factors associated with misclassification of intrapartum stillbirth: Evidence from a large scale multicentric observational study. Acta obstetricia et gynecologica Scandinavica 2020. link 12 Price S. Stillbirth Still a Problem in Texas: TMA Develops New Recommendations. Texas medicine 2018. link 13 Daly LM, Gardener G, Bowring V, Burton W, Chadha Y, Ellwood D et al.. Care of pregnant women with decreased fetal movements: Update of a clinical practice guideline for Australia and New Zealand. The Australian & New Zealand journal of obstetrics & gynaecology 2018. link 14 Ladhani NNN, Fockler ME, Stephens L, Barrett JFR, Heazell AEP. No. 369-Management of Pregnancy Subsequent to Stillbirth. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2018. link 15 Hirst JE, Villar J, Victora CG, Papageorghiou AT, Finkton D, Barros FC et al.. The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH-21. BJOG : an international journal of obstetrics and gynaecology 2018. link 16 Martínez-Serrano P, Palmar-Santos AM, Solís-Muñoz M, Álvarez-Plaza C, Pedraz-Marcos A. Midwives' experience of delivery care in late foetal death: A qualitative study. Midwifery 2018. link 17 Nuzum D, Meaney S, O'Donohue K. Communication skills in Obstetrics: what can we learn from bereaved parents?. Irish medical journal 2017. link 18 Dean E. Pregnancy loss and the death of a baby. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 19 . Majority of stillbirth cases remain unexplained. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 20 Lisy K, Peters MD, Riitano D, Jordan Z, Aromataris E. Provision of Meaningful Care at Diagnosis, Birth, and after Stillbirth: A Qualitative Synthesis of Parents' Experiences. Birth (Berkeley, Calif.) 2016. link 21 Nuzum D, Meaney S, O'Donoghue K. The Place of Faith for Consultant Obstetricians Following Stillbirth: A Qualitative Exploratory Study. Journal of religion and health 2016. link 22 Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M et al.. Stillbirths: recall to action in high-income countries. Lancet (London, England) 2016. link01020-X) 23 Uematsu M, Kitahara G, Sameshima H, Osawa T. Serum selenium and liposoluble vitamins in Japanese Black cows that had stillborn calves. The Journal of veterinary medical science 2016. link 24 Andrews WW. What is new in stillbirth?: important recent articles. Obstetrics and gynecology 2015. link 25 Koshida S, Ono T, Tsuji S, Murakami T, Takahashi K. Recommendations for preventing stillbirth: a regional population-based study in Japan during 2007-2011. The Tohoku journal of experimental medicine 2015. link 26 DiMiceli-Zsigmond M, Williams AK, Richardson MG. Expecting the Unexpected: Perspectives on Stillbirth and Late Termination of Pregnancy for Fetal Anomalies. Anesthesia and analgesia 2015. link 27 Collins JH. Umbilical cord accidents and legal implications. Seminars in fetal & neonatal medicine 2014. link 28 Nuzum D, Meaney S, O'Donoghue K. The impact of stillbirth on consultant obstetrician gynaecologists: a qualitative study. BJOG : an international journal of obstetrics and gynaecology 2014. link 29 Brown R, Wijekoon JH, Fernando A, Johnstone ED, Heazell AE. Continuous objective recording of fetal heart rate and fetal movements could reliably identify fetal compromise, which could reduce stillbirth rates by facilitating timely management. Medical hypotheses 2014. link 30 Farrow VA, Goldenberg RL, Fretts R, Schulkin J. Psychological impact of stillbirths on obstetricians. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 2013. link 31 Kelley MC, Trinidad SB. Silent loss and the clinical encounter: Parents' and physicians' experiences of stillbirth-a qualitative analysis. BMC pregnancy and childbirth 2012. link 32 Heazell AE, McLaughlin MJ, Schmidt EB, Cox P, Flenady V, Khong TY et al.. A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth. BJOG : an international journal of obstetrics and gynaecology 2012. link 33 Downe S, Kingdon C, Kennedy R, Norwell H, McLaughlin MJ, Heazell AE. Post-mortem examination after stillbirth: views of UK-based practitioners. European journal of obstetrics, gynecology, and reproductive biology 2012. link 34 Yakoob MY, Ali MA, Ali MU, Imdad A, Lawn JE, Van Den Broek N et al.. The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths. BMC public health 2011. link 35 Lynch E. A death before life. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2010. link 36 Duke W, Shin M, Correa A, Alverson CJ. Survey of knowledge, attitudes, and practice management patterns of Atlanta-area obstetricians regarding stillbirth. Women's health issues : official publication of the Jacobs Institute of Women's Health 2010. link 37 Facchinetti F, Reddy U, Stray-Pedersen B, Baronciani D, Requejo JH. International issues in stillbirth. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 2008. link 38 Robson S, Thompson J, Ellwood D. Obstetric management of the next pregnancy after an unexplained stillbirth: an anonymous postal survey of Australian obstetricians. The Australian & New Zealand journal of obstetrics & gynaecology 2006. link 39 Leduc L. RETIRED: Stillbirth and bereavement: guidelines for stillbirth investigation. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2006. link32172-7) 40 Spong CY, Erickson K, Willinger M, Hankins GD, Schulkin J. Stillbirth in obstetric practice: report of survey findings. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 2003. link 41 Bartellas E, Van Aerde J. Bereavement support for women and their families after stillbirth. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2003. link30209-2) 42 Tham WL, Tan KH, Tee CS, Yeo GS. Confidential enquiry of stillbirths in current obstetric practice. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 1999. link00133-7) 43 Fickling KF. Stillborn studies: ministering to bereaved parents. Journal of pastoral care 1993. link 44 Biben M. Stillbirth of twins in a squirrel monkey (Saimiri boliviensis peruviensis). Journal of medical primatology 1993. link 45 Andersen KV, Lange AP, Helweg-Larsen K. A perinatal audit of stillbirths in three Danish countries. Scandinavian journal of social medicine 1991. link 46 Rumpler Y, Warter S, Hauwy M, Brun B. Stillborn triploid complex hybrid of lemurs (Eulemur macaco x E. coronatus). Cytogenetics and cell genetics 1990. link 47 Lockwood S, Blackwood M. Parental reactions to stillbirth. Australian family physician 1983. link 48 Ampofo DA. Stillbirth and its prevention in Ghana. Ghana medical journal 1971. link

    Original source

    1. [1]
      Stillbirths Occur in the U.S. More Often Than Reported. — Roush K The American journal of nursing (2026)
    2. [2]
      Post-Mortem Imaging to Investigate the Causes of Stillbirth in Australia: Views of Parents, Midwives and Obstetricians. — Loughnan SA, Wojcieszek AM, Singline L, Griffin A, Boyle FM, Ellwood D et al. Journal of medical imaging and radiation oncology (2025)
    3. [3]
      Determinants of stillbirths in sub-Saharan Africa: A systematic review. — Mukherjee A, Di Stefano L, Blencowe H, Mee P BJOG : an international journal of obstetrics and gynaecology (2024)
    4. [4]
      International progress on stillbirth reduction: Changes in Stillbirth Rates in Selected Low and Middle-Income Countries from 2000 to 2021. — Goldenberg RL, Saleem S, Aziz A, McClure EM Seminars in perinatology (2024)
    5. [5]
      Gaps in Stillbirth Bereavement Care: A Cross-Sectional Survey of U.S. Hospitals by Birth Volume. — Gold KJ, Boggs ME, Plegue MA Maternal and child health journal (2024)
    6. [6]
      A systematic review of behaviour change techniques used in the context of stillbirth prevention. — Escañuela Sánchez T, O Donoghue K, Byrne M, Meaney S, Matvienko-Sikar K Women and birth : journal of the Australian College of Midwives (2023)
    7. [7]
      Never Tell a Mother. — Ibitayo K Nursing for women's health (2023)
    8. [8]
      Exploring the relationship between intimate partner violence during pregnancy and stillbirths. — Khatlani K, Azam I, Baqir M, Mehmood A, Pasha-Razzak O Injury (2023)
    9. [9]
      An exploration of health workers' experiences in providing bereavement care to mothers following a stillbirth: results from a subnational level health system in Uganda. — Ssegujja E, Ddumba I, Andipatin M BMC pregnancy and childbirth (2023)
    10. [10]
      No. 394-Stillbirth Investigation. — Leduc L Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2020)
    11. [11]
      The burden of and factors associated with misclassification of intrapartum stillbirth: Evidence from a large scale multicentric observational study. — Kc A, Berkelhamer S, Gurung R, Hong Z, Wang H, Sunny AK et al. Acta obstetricia et gynecologica Scandinavica (2020)
    12. [12]
      Stillbirth Still a Problem in Texas: TMA Develops New Recommendations. — Price S Texas medicine (2018)
    13. [13]
      Care of pregnant women with decreased fetal movements: Update of a clinical practice guideline for Australia and New Zealand. — Daly LM, Gardener G, Bowring V, Burton W, Chadha Y, Ellwood D et al. The Australian & New Zealand journal of obstetrics & gynaecology (2018)
    14. [14]
      No. 369-Management of Pregnancy Subsequent to Stillbirth. — Ladhani NNN, Fockler ME, Stephens L, Barrett JFR, Heazell AEP Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2018)
    15. [15]
      The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH-21 — Hirst JE, Villar J, Victora CG, Papageorghiou AT, Finkton D, Barros FC et al. BJOG : an international journal of obstetrics and gynaecology (2018)
    16. [16]
      Midwives' experience of delivery care in late foetal death: A qualitative study. — Martínez-Serrano P, Palmar-Santos AM, Solís-Muñoz M, Álvarez-Plaza C, Pedraz-Marcos A Midwifery (2018)
    17. [17]
      Communication skills in Obstetrics: what can we learn from bereaved parents? — Nuzum D, Meaney S, O'Donohue K Irish medical journal (2017)
    18. [18]
      Pregnancy loss and the death of a baby. — Dean E Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2016)
    19. [19]
      Majority of stillbirth cases remain unexplained. Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2016)
    20. [20]
      Provision of Meaningful Care at Diagnosis, Birth, and after Stillbirth: A Qualitative Synthesis of Parents' Experiences. — Lisy K, Peters MD, Riitano D, Jordan Z, Aromataris E Birth (Berkeley, Calif.) (2016)
    21. [21]
      The Place of Faith for Consultant Obstetricians Following Stillbirth: A Qualitative Exploratory Study. — Nuzum D, Meaney S, O'Donoghue K Journal of religion and health (2016)
    22. [22]
      Stillbirths: recall to action in high-income countries. — Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M et al. Lancet (London, England) (2016)
    23. [23]
      Serum selenium and liposoluble vitamins in Japanese Black cows that had stillborn calves. — Uematsu M, Kitahara G, Sameshima H, Osawa T The Journal of veterinary medical science (2016)
    24. [24]
      What is new in stillbirth?: important recent articles. — Andrews WW Obstetrics and gynecology (2015)
    25. [25]
      Recommendations for preventing stillbirth: a regional population-based study in Japan during 2007-2011. — Koshida S, Ono T, Tsuji S, Murakami T, Takahashi K The Tohoku journal of experimental medicine (2015)
    26. [26]
      Expecting the Unexpected: Perspectives on Stillbirth and Late Termination of Pregnancy for Fetal Anomalies. — DiMiceli-Zsigmond M, Williams AK, Richardson MG Anesthesia and analgesia (2015)
    27. [27]
      Umbilical cord accidents and legal implications. — Collins JH Seminars in fetal & neonatal medicine (2014)
    28. [28]
      The impact of stillbirth on consultant obstetrician gynaecologists: a qualitative study. — Nuzum D, Meaney S, O'Donoghue K BJOG : an international journal of obstetrics and gynaecology (2014)
    29. [29]
      Continuous objective recording of fetal heart rate and fetal movements could reliably identify fetal compromise, which could reduce stillbirth rates by facilitating timely management. — Brown R, Wijekoon JH, Fernando A, Johnstone ED, Heazell AE Medical hypotheses (2014)
    30. [30]
      Psychological impact of stillbirths on obstetricians. — Farrow VA, Goldenberg RL, Fretts R, Schulkin J The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2013)
    31. [31]
      Silent loss and the clinical encounter: Parents' and physicians' experiences of stillbirth-a qualitative analysis. — Kelley MC, Trinidad SB BMC pregnancy and childbirth (2012)
    32. [32]
      A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth. — Heazell AE, McLaughlin MJ, Schmidt EB, Cox P, Flenady V, Khong TY et al. BJOG : an international journal of obstetrics and gynaecology (2012)
    33. [33]
      Post-mortem examination after stillbirth: views of UK-based practitioners. — Downe S, Kingdon C, Kennedy R, Norwell H, McLaughlin MJ, Heazell AE European journal of obstetrics, gynecology, and reproductive biology (2012)
    34. [34]
      The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths. — Yakoob MY, Ali MA, Ali MU, Imdad A, Lawn JE, Van Den Broek N et al. BMC public health (2011)
    35. [35]
      A death before life. — Lynch E Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2010)
    36. [36]
      Survey of knowledge, attitudes, and practice management patterns of Atlanta-area obstetricians regarding stillbirth. — Duke W, Shin M, Correa A, Alverson CJ Women's health issues : official publication of the Jacobs Institute of Women's Health (2010)
    37. [37]
      International issues in stillbirth. — Facchinetti F, Reddy U, Stray-Pedersen B, Baronciani D, Requejo JH The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2008)
    38. [38]
      Obstetric management of the next pregnancy after an unexplained stillbirth: an anonymous postal survey of Australian obstetricians. — Robson S, Thompson J, Ellwood D The Australian & New Zealand journal of obstetrics & gynaecology (2006)
    39. [39]
      RETIRED: Stillbirth and bereavement: guidelines for stillbirth investigation. — Leduc L Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2006)
    40. [40]
      Stillbirth in obstetric practice: report of survey findings. — Spong CY, Erickson K, Willinger M, Hankins GD, Schulkin J The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2003)
    41. [41]
      Bereavement support for women and their families after stillbirth. — Bartellas E, Van Aerde J Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2003)
    42. [42]
      Confidential enquiry of stillbirths in current obstetric practice. — Tham WL, Tan KH, Tee CS, Yeo GS International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (1999)
    43. [43]
      Stillborn studies: ministering to bereaved parents. — Fickling KF Journal of pastoral care (1993)
    44. [44]
      Stillbirth of twins in a squirrel monkey (Saimiri boliviensis peruviensis). — Biben M Journal of medical primatology (1993)
    45. [45]
      A perinatal audit of stillbirths in three Danish countries. — Andersen KV, Lange AP, Helweg-Larsen K Scandinavian journal of social medicine (1991)
    46. [46]
      Stillborn triploid complex hybrid of lemurs (Eulemur macaco x E. coronatus). — Rumpler Y, Warter S, Hauwy M, Brun B Cytogenetics and cell genetics (1990)
    47. [47]
      Parental reactions to stillbirth. — Lockwood S, Blackwood M Australian family physician (1983)
    48. [48]
      Stillbirth and its prevention in Ghana. — Ampofo DA Ghana medical journal (1971)
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