What Is the Prognosis for HIE Related to a Difficult Birth?

Associated Conditions, Birth Injury

orange, yellow and purple arrows emerging from blue circle, indicating different possible outcomes from a single event

Hypoxic ischemic encephalopathy (HIE) caused by a difficult birth can have serious long-term consequences. The prognosis for children with HIE can vary, depending on several factors. Read on to learn more about HIE, typical prognosis, treatments, and what to do if your child’s injury could have been prevented.

What is HIE?

HIE can be the result of brain damage in newborns, caused by a shortage of oxygen and/or a shortage of blood flow to the brain. When the brain does not receive sufficient oxygen, cell death can occur, leading to subsequent brain damage.

The causes of HIE include various medical complications and, in some cases, medical malpractice. Some examples of hypoxic ischemic encephalopathy causes include:

  • Umbilical cord complications, such as compression of the cord
  • Infections
  • Placental complications, such as an abruption or placenta previa
  • Uterine complications, such as a rupture
  • Improper monitoring of the fetal heartbeat
  • Premature birth, which puts the newborn at greater risk of HIE
  • Prolonged labor, which can place undue stress on the newborn
  • Failure to diagnose or treat a neonatal condition, such as respiratory distress

Signs and symptoms of HIE may include breathing or feeding problems, seizures, issues with reflexes, lack of alertness or consciousness, issues with muscle tone, and low APGAR scores.

What is the Prognosis for HIE, and What Can Influence That Prognosis?

HIE in infants can lead to some serious complications. Unfortunately, many infants with HIE can develop permanent brain damage and other disorders, such as cerebral palsy, epilepsy, hearing and vision problems, and other cognitive disabilities. Brain injury from HIE is not always readily apparent, and it can take years to see the full extent of a child’s developmental delays and disabilities as a result of a hypoxic brain injury during birth.

“While the majority of infants who are exposed to perinatal hypoxia-ischemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischemic encephalopathy (HIE) or NE if the diagnosis is unclear,” notes one study by the National Institutes of Health. “Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioral outcome of the child.”

There are several factors that can influence a child’s prognosis. Doctors typically diagnose HIE in one of three stages, ranging from mild (Stage I) to moderate (Stage II) to severe (Stage III). Hypoxic ischemic encephalopathy stages are based on various factors, including the extent of the brain injury; the length of time that the brain was deprived of oxygen; how quickly the newborn receives therapeutic care; and the strength of the medical care the newborn receives after birth.

It is difficult to predict the full extent that HIE will have on a child, partly because many associated conditions and symptoms can take years to develop. HIE is one of the leading causes of infant mortality in the U.S., and it is estimated that about 15 to 20% of infants with HIE die within the first week. Of the survivors, an estimated 25% will have permanent brain damage. HIE often results in cognitive impairments, learning difficulties, and physical disabilities.

The main, immediate HIE treatment is called therapeutic hypothermia, and it involves cooling the brain and body for three days, whether through a cooling cap or whole-body cooling. Research has shown that this treatment can help considerably with mild to severe HIE, reducing the extent of permanent brain damage. As a result, therapeutic hypothermia has become the standard of care, to be provided within six hours of oxygen deprivation.

It is important to note that while there is no cure for HIE, there are several treatments and therapies that can help improve various functions and minimize symptoms of associated conditions, such as cerebral palsy. Physical, occupational, speech, and behavioral therapies are just some examples.

What Can You Do if Your Child has Experienced HIE as the Result of a Difficult Birth?

First and foremost, be sure your child is receiving the medical care they need and consult with your child’s medical providers regarding the treatments and therapies that will be of the greatest benefit. If the difficulties in your child’s birth could have been prevented or mitigated by competent medical care, you may have a valid claim for medical malpractice against the practitioner and hospital. Consult with an experienced medical malpractice attorney to discuss your legal rights and options.

The Cerebral Palsy Family Lawyers at Janet, Janet & Suggs have over 40 years of experience with birth injury medical malpractice cases. We have a nationally recognized track record of successful verdicts that demonstrate our commitment to working for justice and fair compensation. Our aim is to achieve justice and compensation for victims of birth injury medical malpractice, and there are no fees unless your case is won. Contact us for a free consultation to discuss your case and understand your rights.



Claire Surles, RN
Reviewed by:
Claire Surles, RN
Registered Nurse

Claire comes to JJS after a 10-year career as a labor and delivery nurse. She dedicated her hospital efforts to advocating for families, providing the safest birthing environment possible as Newborn Admission Nurse at UMMC St. Joseph Medical Center in Towson, Maryland. Her passion for helping those who experienced losses at any stage of gestation led to her appointment as Coordinator of the hospital’s ROOTS perinatal loss program. READ FULL BIO

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