Newborns with mild hypoxic-ischemic encephalopathy usually do not receive cooling treatment. However, some of these newborns may develop neurological problems later in life. This observational study aims to evaluate whether early brain monitoring and measurements of brain oxygen levels are associated with neurological outcomes in newborns with mild hypoxic-ischemic encephalopathy. Newborns will be monitored during the first 72 hours after birth as part of routine clinical care. Neurological assessments will be performed during early infancy and later follow-up. The findings of this study may help improve early risk assessment and support closer monitoring of newborns who may be at increased risk for unfavorable neurological outcomes.
Who can participate
Age range0 Hours – 6 Hours
SexALL
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Inclusion criteria
✓. Gestational age and postnatal age:
✓. Blood gas criteria
✓. pH ≤ 7.00 or base deficit ≥ 16 mmol/L
✓. OR, if pH is 7.01-7.15 or base deficit is 10-15.9 mmol/L, the presence of both:
✓. Clinical evidence of encephalopathy Findings consistent with Sarnat and Sarnat Stage 1 (mild) encephalopathy. Mild, moderate, or severe abnormalities may be present in at least one of the six categories (level of consciousness, spontaneous activity, posture, tone, primitive reflexes \[suck and Moro\], autonomic nervous system), provided that no more than two categories show moderate or severe findings.
Exclusion criteria
✕. Normal neurological examination Newborns with a completely normal neurological examination according to Sarnat and Sarnat staging.
✕. Moderate or severe encephalopathy within the first 6 hours of life
✕. Clinical findings consistent with moderate or severe encephalopathy during the first 6 hours after birth.
What they're measuring
1
Neurological Outcomes in Neonates with Mild Hypoxic-ischemic Encephalopathy
✕. aEEG findings consistent with moderate or severe encephalopathy requiring therapeutic hypothermia.
✕. Evidence of electrographic seizure activity on aEEG monitoring.
✕. Sarnat and Sarnat criteria for moderate-severe encephalopathy Findings consistent with moderate or severe encephalopathy in three or more Sarnat categories, classified as moderate or severe hypoxic-ischemic encephalopathy.
✕. Contraindications to therapeutic hypothermia, including: