Findings suggesting a cause other than acute intrapartum hypoxia:
(1) umbilical arterial base deficit < 12 mmol/L
(2) umbilical arterial pH > 7.00
(3) presence of major or multiple congenital abnormalities
(4) presence of major or multiple metabolic abnormalities (not directly caused by organ dysfunction)
(5) central nervous system or systemic infection
(6) evidence on early imaging studies of longstanding neurological abnormalities
(7) presence of intrauterine growth retardation
(8) reduced fetal heart rate variability from the onset of labor (all during labor)
(9) microcephaly at birth
(10) major antenatal placental abruption
(11) extensive chorioamnionitis
(12) congenital coagulation disorder in the infant
(13) presence of major antenatal risk factors for cerebral palsy (preterm birth at < 34 weeks gestation, multiple gestation, or autoimmune disease)
(14) presence of major postnatal risk factors for cerebral palsy (infectious encephalitis, prolonged hypotension, hypoxia due to severe respiratory disease)
(15) a sibling with cerebral palsy, especially of the same type
where:
• I am not sure if the presence of a sibling with cerebral palsy would be influenced by the sibling being of the same multiple pregnancy vs a separate gestation.
• Prolonged rupture of the membranes can be a cause of chorioamnionitis.
