What is Hypoxic Ischemic Encephalopathy (HIE)?
Hypoxic Ischemic Encephalopathy (HIE) is defined as the lack of oxygen to the brain due
to an interruption or cessation of blood flow to the brain (Cleveland Clinic, 2023). HIE is mostly
prevalent in newborns or the fetus, but HIE can also occur in children and older adults. While
HIE mainly impacts the brain, other major organs can also be affected due to the lack of
adequate oxygenation and loss of brain functioning (NIH, 2024). HIE can have fatal outcomes or
it can result in severe brain injury. The severity of these outcomes is contingent on several
factors, including the amount of time that the brain has gone without oxygen, the areas of the
brain that have been affected, and the recovering capabilities of the individual (NIH, 2024).
What can cause HIE?
HIE can be caused by a multitude of events. HIE can occur at any point during pregnancy
or during the birthing process. Risk factors may include high blood pressure during pregnancy or
birth (preeclampsia) or low blood pressure during delivery, maternal infections or infections
passed on to the fetus or newborn, insufficient placental blood flow, poor positioning of the
fetus during delivery, or premature birth (NIH, 2024). Children and adults can also be affected by
HIE as a result of severe respiratory distress that can be a result of drowning, overdose, or
poisoning (Cleveland Clinic, 2023; Hope for HIE, 2025).
Preventative Measures
Prevention of HIE in fetuses and newborns consists of obtaining routine prenatal care
throughout your pregnancy. Your clinician should be able to perform thorough assessments and
screenings to identify any risk factors that can increase the chance of HIE occurring before,
during, or after birth (Cleveland Clinic, 2023). Fetal heart monitoring is used during prenatal
visits and during labor to observe if the fetus is experiencing any changes in oxygenation (HIE
Help Center, 2024).
Any sign of abnormalities in the fetal heart rate should prompt the provider
to immediately intervene to determine the source of the change in the fetal heart rate. Failure to
promptly intervene can increase the severity of the injury, which ultimately increases the fetal
risk of HIE.
Loss of oxygen to the baby’s brain can have devastating consequences. Vigilance by
medical staff during labor and delivery is essential, to correct any signs of fetal distress in the
baby and to evaluate the need for an urgent or emergent cesarean section delivery to prevent
permanent harm. While not every case of severe hypoxia and not every birth injury is due to
substandard medical care, in some instances the injury or the extent of the injury was avoidable,
and was due to errors made in the management of the medical care.
If your child or the child of someone close to you has suffered a serious birth injury
and you have questions about the care, call our office for a Free Consultation. Call 215-557-
7500.
References
Hypoxic Ischemic Encephalopathy. (2024). National Institute of Neurological Disorders
and Stroke. https://www.ninds.nih.gov/health-information/disorders/hypoxic-
ischemic-encephalopathy
Hypoxic-Ischemic Encephalopathy & Fetal Heart Monitoring. (2024, July 22). HIE Help
Center. https://hiehelpcenter.org/medical/prevention/fetal-heart-monitoring-during-
delivery/
Hypoxic-Ischemic Encephalopathy (HIE): Symptoms. (2023, October 6). Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/hypoxic-ischemic-encephalopathy-hie
What Causes HIE - Hope for HIE - Hypoxic Ischemic Encephalopathy. (2025, July 7).
Hope for HIE - Hypoxic Ischemic Encephalopathy.
https://hopeforhie.org/whatishie/causes/#hie_from_causes_in_childhood
