{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T09:42:38Z","timestamp":1766137358494,"version":"3.37.3"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"DOI":"10.13039\/100006792","name":"Hartwell Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006792","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003This study examined patterns of care after birth in newborns treated with therapeutic hypothermia to identify remediable causes for the poorer outcomes observed in outborn infants.<\/jats:p><jats:p>\n          Study Design\u2003This was a secondary analysis of 150 newborns (68 outborn) prospectively enrolled at our center in the Vermont Oxford Neonatal Encephalopathy Registry from January 2008 to October 2016.<\/jats:p><jats:p>\n          Results\u2003The 5-minute Apgar's score and cord pH value did not differ, but cord blood gases were obtained far less frequently in outborns (p\u2009=\u20090.002). Outborns needed more chest compressions (p\u2009=\u20090.01) and epinephrine (p\u2009=\u20090.04), and had more brain injury on neuroimaging (p\u2009=\u20090.05). Outborns took longer to reach target hypothermia temperature (p\u2009&lt;\u20090.0001).<\/jats:p><jats:p>\n          Conclusion\u2003The lack of cord gas values and longer time to reach target temperature observed in the outborns are two observed differences in care that can be potentially remedied by providing education and resources at delivering hospitals in rapid identification of hypothermia candidates, though further research is needed to define the effects of such measures. Possible solutions are also discussed here.<\/jats:p>","DOI":"10.1055\/s-0040-1702990","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:01:20Z","timestamp":1583193680000},"page":"e21-e25","source":"Crossref","is-referenced-by-count":4,"special_numbering":"S","title":["Identifying Ways to Fix Outcome Disparities among Outborns Needing Therapeutic Hypothermia"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0185-6500","authenticated-orcid":false,"given":"Mary Jo A.","family":"Harbert","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachelle","family":"Sey","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Arnell","sequence":"additional","affiliation":[{"name":"Research Projects and Administration, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maynard","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,3,2]]},"reference":[{"issue":"01","key":"ref1","first-page":"CD003311","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","author":"S E Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.pediatrneurol.2004.06.014","article-title":"Moderate hypothermia in neonatal encephalopathy: efficacy outcomes","volume":"32","author":"D J Eicher","year":"2005","journal-title":"Pediatr Neurol"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1038\/pr.2012.103","article-title":"Effect of inborn vs. outborn delivery on neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy: secondary analyses of the NICHD whole-body cooling trial","volume":"72","author":"G Natarajan","year":"2012","journal-title":"Pediatr Res"},{"issue":"04","key":"ref4","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":"ref5","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"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/1471-2431-12-84","article-title":"The Vermont Oxford Neonatal Encephalopathy Registry: rationale, methods, and initial results","volume":"12","author":"R H Pfister","year":"2012","journal-title":"BMC Pediatr"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/jp.2012.144","article-title":"Therapeutic hypothermia during neonatal transport: data from the California Perinatal Quality Care Collaborative (CPQCC) and California Perinatal Transport System (CPeTS) for 2010","volume":"33","author":"V P Akula","year":"2013","journal-title":"J Perinatol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.brainres.2007.03.083","article-title":"\u201cTherapeutic time window\u201d duration decreases with increasing severity of cerebral hypoxia-ischaemia under normothermia and delayed hypothermia in newborn piglets","volume":"1154","author":"O Iwata","year":"2007","journal-title":"Brain Res"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3389\/fnins.2014.00040","article-title":"The mechanisms and treatment of asphyxial encephalopathy","volume":"8","author":"G Wassink","year":"2014","journal-title":"Front Neurosci"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1172\/JCI119153","article-title":"Dramatic neuronal rescue with prolonged selective head cooling after ischemia in fetal lambs","volume":"99","author":"A J Gunn","year":"1997","journal-title":"J Clin Invest"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1159\/000353948","article-title":"Time is brain: starting therapeutic hypothermia within three hours after birth improves motor outcome in asphyxiated newborns","volume":"104","author":"M Thoresen","year":"2013","journal-title":"Neonatology"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.jpeds.2014.12.061","article-title":"A randomized clinical trial of therapeutic hypothermia mode during transport for neonatal encephalopathy","volume":"166","author":"V P Akula","year":"2015","journal-title":"J Pediatr"}],"container-title":["American Journal of 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