An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

• Published in: PLoS ONE 2023, Vol.18 (12), p.e0295759
• Main Authors: Okulu, Emel, Hirfanoglu, Ibrahim Murat, Satar, Mehmet, Erdeve, Omer, Koc, Esin, Ozlu, Ferda, Gokce, Mahmut, Armangil, Didem, Tunc, Gaffari, Demirel, Nihal, Unal, Sezin, Ozdemir, Ramazan, Deveci, Mehmet Fatih, Akar, Melek, Demirel, Melike Kefeli, Çetinkaya, Merih, Buker, Halime Sema Can, Karagöl, Belma Saygili, Yaprak, Deniz, Akcan, Abdullah Baris, Anik, Ayse, Narter, Fatma, Arayici, Sema, Yildirim, Egemen, Akin, Ilke Mungan, Sahin, Ozlem, Ozdemir, Ozgul Emel Bulut, Ovali, Fahri, Akin, Mustafa Ali, Celik, Yalcin, Orman, Aysen, Uslu, Sinan, Ozkan, Hilal, Koksal, Nilgun, Tastekin, Ayhan, Gunduz, Mehmet, Arisoy, Ayse Engin, Gurpinar, Resat, Ors, Rahmi, Altunhan, Huseyin, Kececi, Ramazan, Yildizdas, Hacer Yapicioglu, Terek, Demet, Ates, Mehmet, Kader, Sebnem, Mutlu, Mehmet, Çelik, Kiymet, Yucesoy, Ebru, Mert, Mustafa Kurthan, Gulasi, Selvi, Kucuktasci, Kazim, Arman, Didem, Hekimoglu, Berna, Gultekin, Nazli Dilay, Celik, Hasan Tolga, Kahvecioglu, Dilek, Akyildiz, Can, Taskin, Erdal, Ciftdemir, Nukhet Aladag, Uygun, Saime Sundus, Kaya, Tugba Barsan, Akdag, Arzu, Yilmaz, Aslan
• Format: Report
• Language: English
• Subjects: Encephalopathy; Infants (Newborn); Mortality; Neonatal intensive care; Neonatology; United Kingdom
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0295759

Background Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants [greater than or equal to]36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. Methods The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at [greater than or equal to]34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. Results The incidence of HIE among infants born at [greater than or equal to]36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HIE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). Conclusion The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether