Effect of Allopurinol for Hypoxic-ischemic Brain Injury on Neurocognitive Outcome

Inclusion criteria Term and near-term infants with a history of disturbed labour who meet at least one criterion of perinatal acidosis (or ongoing resuscitation) and at least two early clinical signs of potentially evolving encephalopathy as defined herein: Severe perinatal metabolic acidosis or ongoing cardiopulmonary resuscitation at 5 min after birth: At least 1 out of the following 5 criteria must be met * Umbilical (or arterial or reliable venous) blood gas within 30 min after birth with pH\<7.0 * Umbilical (or arterial or reliable venous) blood gas within 30 min after birth with base deficit ≥16 mmol/l * Need for ongoing cardiac massage at/beyond 5 min postnatally * Need for adrenalin administration during resuscitation * APGAR score ≤5 at 10min AND Early clinical signs of potentially evolving encephalopathy: At least 2 out of the following 4 criteria must be met: * Altered state of consciousness (reduced or absent response to stimulation or hyperexcitability) * Severe muscular hypotonia or hypertonia, * Absent or insufficient spontaneous respiration (e.g., gasping only) with need for respiratory support at 10 min postnatally * Abnormal primitive reflexes (absent suck or gag or corneal or Moro reflex) or abnormal movements (e.g., potential clinical correlates of seizure activity) Exclusion criteria * gestational age below 36 weeks * birth weight below 2500 g * postnatal age \>30min at the end of screening phase * severe congenital malformation or syndrome requi…