Perinatal Asphyxia and Other Common Causes of Perinatal Depression

Sir.—In the October 1989 issue of AJDC, the editorial by Bedrick¹ appropriately warns that "perinatal asphyxia is a symptom complex indicative of an underlying pathophysiologic process" and that perinatal depression "may be a more appropriate descriptive term." I agree that perinatal asphyxia is only one cause of perinatal depression, and for many years I have taught residents and students the nmemonic HIDEH as a reminder of the other common causes:

H: for hemorrhage (subdural in traumatic deliveries; subarachnoid, intraventricular, or subependymal matrix in premature infants)

I: for infection (bacterial, viral, fungal, etc)

D: for drugs (thiopental sodium [Pentothal], butorphanol tartrate [Stadol], meperidine hydrochloride [Demerol], etc, plus maternal alcohol, heroin, marijuana, etc)

E: for cerebral edema, which may complicate asphyxia, trauma, or infection

H: for severe hypoglycemia, which occurs in an infant of a diabetic or prediabetic mother, or in a small-for-gestational age infant running out of glycogen.