In low risk pregnancies the incidence of stillbirths or neonatal deaths due to intrapartum asphyxia is regarded as a sensitive measure of the quality of intrapartum care2–4. The 4th annual report of the Confidential Enquiry into Stillbirths and Deaths in Infancy5 recently identified sub-optimal care in many intrapartum deaths.
In an earlier study we reported a fall in incidence of hypoxic-ischaemic encephalopathy in term infants during the period 1984–1988 (period B) compared with 1976–1980 (period A) in babies admitted to Derby City Hospital Neonatal Unit1.
The aim of this study was to determine whether there had been a significant fall in incidence of moderate and severe hypoxic-ischaemic encephalopathy in the same neonatal unit, by looking at the period 1992–1996 (period C). Information was also obtained on the subsequent morbidity and mortality of the three grades of hypoxic-ischaemic encephalopathy in the latest study period. The findings were looked at in the context of other changes occurring over the time period of this study such as demographic changes and clinical practice.