Jaiotza inguruko asfixia, jaioberrien heriotza eta arazo neurologikoak eragiten dituen arrazoi nagusietarikoa da. Ezagutzen den tratamendu bakarra hipotermia terapeutikoa da eta hori, asfixia-kasuak bizkortasunez identifikatzeko zailtasunarekin batera, erronka handia da eraginkorrak diren neurri neurobabesleak aplikatzeko. Asfixia gertaera hipoxiko-iskemiko batekin hasten da eta odoljarioaren berrezarpenak jarraitzen dio. Egoera horren aurrean fisiopatologia konplexu bat garatzen da, hainbat ezaugarri berezirekin: eszitotoxikotasuna, mitokondrioen disfuntzioa, hantura, apoptosia eta nekrosia, besteak beste. Garunean garatzen den kaltea denborarekiko mendekoa da eta klinika-arloan entzefalopatia hipoxiko-iskemiko izenarekin ezagutzen da. Kalte horren larritasunaren arabera hipotermia terapeutikoa erabiliko da edo ez. Zelulak egoera hipoxikoetara moldatzen dira eraldaketa epigenetikoen bidez. Oro har, geneak isiltzen dira eraldaketa horien ondorioz, baina oxigenoaren erabilgarritasuna eta zelulen metabolismoa moldatzen duten beste zenbait generen espresioa ere areagotu egiten da. Prozesu epigenetiko garrantzitsuenen artean hipoxiak eragindako faktorearekin (HIF-1) lotutako prozesuak, DNAren metilazioa, mikroRNAk eta histonen eraldaketak daude. Nahiz eta eraldaketa epigenetikoen helburua oxigeno-gabeziara moldatzea izan, garunean gertatutako kalteak handitu ditzakete. Hori dela eta, ikerketa-lan batzuk sendagaiak bilatzen ari dira eraldaketa horiek ekiditeko. Berrikuspen honetan jaiotza inguruko asfixiari buruzko informazio aipagarriena bai eta egoera hipoxiko-iskemikoen aurrean gertatzen diren eraldaketa epigenetiko nagusiak deskribatzen dira. Gako-hitzak: Jaiotza inguruko asfixia, epigenetika, HIF-1, DNA metilazioa, mi-RNA, histonak. Epigenetic modulation in response to perinatal asphyxia Perinatal asphyxia is one of the leading causes of fetal death and neurological problems among neonates. Currently, the only treatment is therapeutic hypothermia, which is a challenge for medicine to identify possible cases of asphyxia earlier and to apply more efficient neuroprotective measures to minimise the sequelae. Asphyxia is characterised by an initial ischaemic hypoxic event and a subsequent restoration of blood flow, both of which are associated with a complex pathophysiology characterised by excitotoxicity, mitochondrial dysfunction, inflammation, apoptosis and cellular necrosis in immature brains. The brain injury produced is time-dependent and the clinical manifestation of perinatal asphyxia is called hypoxic-ischaemic encephalopathy, which depending on its degree of severity will be a candidate for therapeutic hypothermia or not. In turn, epigenetic modifications also occur as a measure of cellular adaptation to hypoxic conditions. This leads to an alteration in gene expression in which, at a global level, there is a silencing of genes, but the expression of certain genes involved in cell metabolism or in increasing oxygen availability, for example, through erythropoietin, is enhanced. Among the most relevant epigenetic processes are the hypoxia-inducible factor HIF-1, DNA methylation, microRNAs and histone modifications. Although the epigenetics involved in perinatal asphyxia contribute to adaptation to new oxygen conditions, such changes can also add to brain damage, so studies are currently underway to develop drugs to reverse these epigenetic alterations. In this review, the most important features of perinatal asphyxia, as well as the most relevant epigenetic modifications associated with a hypoxic ischaemic event, are presented. Keywords: Perinatal asphyxia, epigenetics, HIF-1, DNA metilation, mi-RNA, histones.