Changes in the treatment and outcomes of different severities of neonatal hypoxic ischemic encephalopathy in California: a retrospective cohort study

Carolyn Fall; Rebecca J Baer; Henry C Lee; Gretchen Bandoli; Christina D Chambers

doi:10.1038/s41372-025-02212-5

Changes in the treatment and outcomes of different severities of neonatal hypoxic ischemic encephalopathy in California: a retrospective cohort study

J Perinatol. 2025 Jan 26. doi: 10.1038/s41372-025-02212-5. Online ahead of print.

Authors

Carolyn Fall¹, Rebecca J Baer², Henry C Lee³, Gretchen Bandoli³, Christina D Chambers³

Affiliations

¹ University of Washington, Seattle Children's Hospital, Seattle, WA, USA. cfall1@uw.edu.
² University of California San Diego, University of California San Francisco, San Francisco, CA, USA.
³ University of California, San Diego, Rady Children's Hospital of San Diego, La Jolla, CA, USA.

PMID: 39865163
DOI: 10.1038/s41372-025-02212-5

Abstract

Objective: Evaluate the changes in management and outcomes of Californian infants with hypoxic ischemic encephalopathy (HIE).

Study design: Infants with HIE were identified from a California administrative birth cohort using ICD codes and divided into two epochs, Epoch 1 (2010-2015) and Epoch 2 (2016-2019). Risk ratios (RR) for induced hypothermia (IH) in each epoch and their outcomes were calculated using log-linear regression.

Results: In this cohort, 4779 infants with HIE were identified. Incidence of HIE in California increased yearly from 0.5/1000 California births to a peak of 1.5/1000 births in 2018. The use of IH in infants with mild HIE increased in Epoch 2 compared to Epoch 1. There was no significant difference in outcomes between epochs for infants with mild HIE that received IH including no difference in neonatal seizures.

Conclusion: Significantly more infants with mild HIE received IH since 2015 in California, but no significant difference in outcomes.

Grants and funding

K01 AA027811/AA/NIAAA NIH HHS/United States