{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:12:56Z","timestamp":1790737976064,"version":"4.1.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to compare the antenatal and intrapartum characteristics of newborns at \u226536.0 weeks, who underwent whole-body hypothermia for hypoxic\u2013ischemic encephalopathy (HIE) and had either cesarean or vaginal deliveries.<\/jats:p>\n                  <jats:p>Retrospectively, we identified all non-anomalous singletons at \u226536.0 weeks who had HIE and underwent whole-body hypothermia at a community teaching hospital. Differences in baseline characteristics and intrapartum factors were compared among the cesarean versus vaginal deliveries using chi-square tests. Multivariable Poisson regression models were used to estimate the association between delivery route and various outcomes with adjustment for potential confounders.<\/jats:p>\n                  <jats:p>Of the 32,765 deliveries during the study period, 132 (0.4%) met the inclusion criteria, and among them, 79 (59.8%) had cesarean deliveries, and the remaining 53 (40.1%) had vaginal births. The prenatal care providers (i.e., private, community hospital faculty, or others) differed significantly between the two groups (p\u2009=\u20090.013). Within 60\u2009minutes of hospitalization, the characteristics of fetal heart rate tracing (FHRT) and its category (I, II, or III) did not differ between the groups. Sentinel events occurred among 25.3% of those who had cesarean and 30.2% of those who delivered vaginally (p\u2009=\u20090.556). FHRT 60\u2009minutes prior to delivery did not differ with regard to the presence of decelerations (p\u2009=\u20090.409), and variability (p\u2009=\u20090.199), but whether it was category I, II, or III (p\u2009=\u20090.030) did vary significantly. The likelihood of neonatal seizure (adjusted incidence rate ratio\u2009=\u20091.03; 95% confidence interval: 0.41\u20132.58) and mortality (1.10; 0.03\u201345.5) were similar between the groups.<\/jats:p>\n                  <jats:p>Occurring in approximately 4 per 1,000 deliveries at a community teaching hospital, the majority of singletons who had whole-body cooling had cesarean delivery. While the category of FHRT did not differ significantly within 60\u2009minutes of admission, it did differ 60\u2009minutes before birth.<\/jats:p>","DOI":"10.1055\/a-2811-5092","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:20:28Z","timestamp":1771287628000},"page":"1665-1672","source":"Crossref","is-referenced-by-count":1,"title":["Whole-Body Hypothermia for Hypoxic\u2013Ischemic Encephalopathy and Route of Delivery"],"prefix":"10.1055","volume":"43","author":[{"given":"Sneha","family":"Paranandi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4223-3203","authenticated-orcid":false,"given":"Fabrizio","family":"Zullo","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley Z.","family":"Kovatis","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Christiana Care Health System, Newark, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony C.","family":"Sciscione","sequence":"additional","affiliation":[{"name":"Delaware Center for Maternal-Fetal Medicine of ChristianaCare, Newark, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew K.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneet P.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Delaware Center for Maternal-Fetal Medicine of ChristianaCare, Newark, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:145588","volume-title":"Births: Final data for 2022","author":"M JK Osterman","year":"2024"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"751.e1","DOI":"10.1016\/j.ajog.2022.06.002","article-title":"Trends of neonatal hypoxic-ischemic encephalopathy prevalence and associated risk factors in the United States, 2010 to 2018","volume":"227","author":"C Acun","year":"2022","journal-title":"Am J Obstet Gynecol"},{"issue":"24","key":"ref3","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1001\/jama.2014.16058","article-title":"Effect of depth and duration of cooling on deaths in the NICU among neonates with hypoxic ischemic encephalopathy: A randomized clinical trial","volume":"312","author":"S Shankaran","year":"2014","journal-title":"JAMA"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/AOG.0000000000005392","article-title":"Neonatal hypoxic-ischemic encephalopathy and hypothermia treatment","volume":"143","author":"T Arnautovic","year":"2024","journal-title":"Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"04030","DOI":"10.7189\/jogh.12.04030","article-title":"Therapeutic hypothermia in neonatal hypoxic encephalopathy: A systematic review and meta-analysis","volume":"12","author":"J L Mathew","year":"2022","journal-title":"J Glob Health"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/AOG.0b013e3181aef106","article-title":"ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles","volume":"114","author":"American College of Obstetricians and Gynecologists","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/AOG.0b013e3182004fa9","article-title":"ACOG Practice Bulletin No. 116: Management of intrapartum fetal heart rate tracings","volume":"116","author":"American College of Obstetricians and Gynecologists","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1055\/s-0039-1688998","article-title":"Acidemia can occur despite category I tracing","volume":"37","author":"A M Bruno","year":"2020","journal-title":"Am J Perinatol"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ajog.2023.04.008","article-title":"Three-tiered fetal heart rate interpretation system and adverse neonatal and maternal outcomes: A systematic review and meta-analysis","volume":"229","author":"F Zullo","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"ref10","first-page":"235","article-title":"Proportion of time in category II fetal heart rate tracing and adverse outcomes","volume":"43","author":"K A Cagino","year":"2025","journal-title":"Am J Perinatol"},{"issue":"07","key":"ref11","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1055\/a-2708-4947","article-title":"Characteristics and categories of fetal heart rate tracings and adverse neonatal outcomes at Term","volume":"43","author":"R L Wiley","year":"2026","journal-title":"Am J Perinatol"},{"issue":"9460","key":"ref12","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/S0140-6736(05)17946-X","article-title":"Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: Multicentre randomised trial","volume":"365","author":"P D Gluckman","year":"2005","journal-title":"Lancet"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"e771","DOI":"10.1542\/peds.2009-2441","article-title":"Systemic hypothermia after neonatal encephalopathy: Outcomes of neo.nEURO.network RCT","volume":"126","author":"G Simbruner","year":"2010","journal-title":"Pediatrics"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1001\/archpediatrics.2011.43","article-title":"Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: A randomized controlled trial","volume":"165","author":"S E Jacobs","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"15","key":"ref15","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1056\/NEJMcps050929","article-title":"Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy","volume":"353","author":"S Shankaran","year":"2005","journal-title":"N Engl J Med"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1001\/archneur.1976.00500100030012","article-title":"Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study","volume":"33","author":"H B Sarnat","year":"1976","journal-title":"Arch Neurol"},{"issue":"01","key":"ref17","first-page":"CD003311","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","volume":"2013","author":"S E Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"07","key":"ref18","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1111\/j.1651-2227.1997.tb08581.x","article-title":"The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome","volume":"86","author":"C M Thompson","year":"1997","journal-title":"Acta Paediatr"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0002-9378(03)00908-6","article-title":"Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy","volume":"190","author":"S P Miller","year":"2004","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1542\/peds.2006-1591","article-title":"Predicting outcomes of neonates diagnosed with hypoxemic-ischemic encephalopathy","volume":"118","author":"N Ambalavanan","year":"2006","journal-title":"Pediatrics"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1097\/AOG.0000000000006049","article-title":"ACOG Clinical Practice Guideline No. 10: Intrapartum fetal heart rate monitoring: Interpretation and management","volume":"146","author":"American College of Obstetricians and Gynecologists","year":"2025","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref23","first-page":"CD000013","article-title":"Amnioinfusion for potential or suspected umbilical cord compression in labour","volume":"1","author":"G J Hofmeyr","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"08","key":"ref24","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/OGX.0000000000000215","article-title":"Interventions for intrauterine resuscitation in suspected fetal distress during term labor: A systematic review","volume":"70","author":"L M Bullens","year":"2015","journal-title":"Obstet Gynecol Surv"},{"issue":"25","key":"ref25","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1056\/NEJMoa040405","article-title":"Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery","volume":"351","author":"M B Landon","year":"2004","journal-title":"N Engl J Med"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/01.AOG.0000445580.65983.d2","article-title":"Executive summary: Neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy","volume":"123","author":"American College of Obstetricians and Gynecologists","year":"2014","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2811-5092.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:41:46Z","timestamp":1787611306000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2811-5092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":25,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,8,24]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2811-5092","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2,16]]},"published":{"date-parts":[[2026,2,16]]}}}