Alterations in Brain Structure and Their Association with Umbilical Blood Gases in Neonates with Perinatal Asphyxia

Background Perinatal asphyxia is a leading cause of neonatal morbidity and can induce central nervous system hypoxia with functional sequelae. Current evidence on associated brain structural changes remains limited. This study aimed to determine whether mild perinatal asphyxia correlates with subtle alterations in neonatal cortical structure. Methods Head MRI data from 115 neonates were collected. Using a 1‑minute Apgar score cutoff of 7, neonates were classified into an asphyxia (AS) group and a non‑asphyxia (non‑AS) group. T2, T2‑FLAIR, and 3D T1 sequences were acquired. Gray matter volume, cortical thickness, surface area, and curvature were computed via the uAI Research Portal. Umbilical artery blood gas parameters (including hydrogen ion concentration index, lactate, and base excess) were recorded. Gender, corrected gestational age, and total brain volume were included as covariates. Group differences in gray matter volume and cortical parameters were compared, and their correlations with umbilical artery blood gas indicators were analyzed. Results Relative to the non‑AS group, the AS group exhibited significantly reduced bilateral amygdala volume, left transverse temporal gyrus thickness, and curvature of the left caudal middle frontal gyrus, pars triangularis, supramarginal gyrus, and right inferior temporal gyrus (corrected p  = 0.001–0.046). All these parameters showed significant correlations with umbilical artery blood gas measures ( p  < 0.05). Conclusion A low 1‑minute Apgar score is associated with measurable changes in brain structure and correlates with clinical indicators from umbilical artery blood gas analysis. These findings may provide future imaging evidence for the clinical assessment of perinatal asphyxia.