{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T19:57:15Z","timestamp":1762113435742},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T00:00:00Z","timestamp":1398211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the incidence of moderate to severe neonatal encephalopathy (<jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>) and neonatal seizures without encephalopathy, and the association with metabolic acidemia. Secondly, to investigate the occurrence of suboptimal intrapartum care and its impact on neonatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Clinical audit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two university hospitals in Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Neonates \u226534\u00a0weeks with moderate or severe <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> and neonatal seizures alone, i.e. without encephalopathy, from a population of 71\u00a0189 births, where umbilical blood gases were routinely analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Neonates were categorized depending on the presence of metabolic acidemia at birth by umbilical artery pH\u00a0&lt;\u00a07.00, base deficit \u226512\u00a0mmol\/L. Records were audited for suboptimal care and a decision was made on whether management was assessed to have impacted neonatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Encephalopathy and seizures alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 80 neonates with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> and 30 with seizures alone, of which 48 (60%) and none, respectively, had metabolic acidemia. Suboptimal care could be assessed in 77 and occurred in 28 (36%) <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> cases and in one neonate with seizures alone (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In 47 <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> cases with metabolic acidemia, suboptimal care occurred in 22 (47%) vs. 6\/30 (20%) without metabolic acidemia (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). Suboptimal care had an impact on outcome in 18\/77 (23%) <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> cases but in no cases with seizures alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Suboptimal care was commonly seen with <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>, particularly in neonates with metabolic acidemia, and also affected neonatal outcome. No such associations were found in neonates with seizures alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12381","type":"journal-article","created":{"date-parts":[[2014,3,19]],"date-time":"2014-03-19T16:10:34Z","timestamp":1395245434000},"page":"477-482","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Suboptimal care and metabolic acidemia is associated with neonatal encephalopathy but not with neonatal seizures alone: a population\u2010based clinical audit"],"prefix":"10.1111","volume":"93","author":[{"given":"Maria","family":"Jonsson","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"\u00c5gren","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solveig","family":"Nord\u00e9n\u2010Lindeberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Ohlin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics \u00d6rebro University Hospital \u00d6rebro Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulf","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00574-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7216.1054"},{"key":"e_1_2_8_4_1","unstructured":"2003 ACOG Washington DC"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000230533.62760.ef"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7172.1554"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12658-X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1229"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2005.00390.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.87.3.F176"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6931.743"},{"key":"e_1_2_8_12_1","first-page":"178","volume-title":"Neurology of the newborn","author":"Volpe JJ","year":"2001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412301"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.76.2.F88"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.1.116"},{"key":"e_1_2_8_16_1","first-page":"142","article-title":"Perinatal cerebral infarction","volume":"11","author":"Ment LR","year":"1987","journal-title":"Semin Perinatol"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.6.851"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1976.00500100030012"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(85)90115-X"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(87)90012-9"},{"key":"e_1_2_8_21_1","first-page":"65","article-title":"Fetal heart rate patterns: monitoring, interpretation and management. 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