title: Short-term outcomes of newborns with perinatal acidemia who are not eligible for systemic hypothermia therapy.
abstract: OBJECTIVE
  To determine short-term outcomes of infants who had perinatal acidemia and were evaluated for hypothermia therapy but did not qualify based on a standardized neurologic examination.
  
  
  METHODS
  Retrospective, single-site cohort study of inborn infants of ≥ 36 weeks gestation who had perinatal acidemia from October 2005-September 2008 and had a standardized neurologic examination performed by a certified neonatologist to assess eligibility for hypothermia therapy. An abnormal short-term nursery outcome was defined as death, seizures, brain magnetic resonance imaging consistent with hypoxic-ischemic encephalopathy, abnormal neurologic examination at discharge, gastrostomy tube feeding, or inability to nipple all feeds beyond the first week of age.
  
  
  RESULTS
  One hundred forty-four (0.3%) of 46 887 newborns with perinatal acidemia had a neurologic examination performed that was either normal (n = 29) or consistent with mild encephalopathy (1 or 2 abnormal categories; n = 60). Of the latter infants classified as having mild encephalopathy, 12 (20%) experienced an abnormal short-term outcome (feeding difficulties, n = 8; abnormal neurologic examination at discharge, n = 7; abnormal brain magnetic resonance imaging, n = 6; seizures, n = 5; gastrostomy, n = 1; or death, n = 1).
  
  
  CONCLUSIONS
  Twenty percent of newborns with perinatal acidemia and a neurologic examination that revealed only mild encephalopathy had abnormal short-term outcomes that could be attributed to the encephalopathy. Adjunctive tools or biomarkers for optimal assessment of infants with fetal acidemia for hypothermia therapy are needed.
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA.
authors.forename: Tara L
authors.initials: TL
authors.lastname: DuPont
authors.forename: Lina F
authors.initials: LF
authors.lastname: Chalak
authors.forename: Michael C
authors.initials: MC
authors.lastname: Morriss
authors.forename: P Jeannette
authors.initials: PJ
authors.lastname: Burchfield
authors.forename: Lucy
authors.initials: L
authors.lastname: Christie
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sánchez
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index