{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:44:33Z","timestamp":1777589073003,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,29]],"date-time":"2014-01-29T00:00:00Z","timestamp":1390953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypoxic\u2013ischemic encephalopathy (<jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content>) is one of the most critical pathologic conditions in neonatal medicine due to the potential for neurological deficits in later life. We investigated the incidence of term infants with moderate or severe <jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan and identified prognostic risk factors for poor outcome in <jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on 227 infants diagnosed with moderate or severe <jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content> and born between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2008 were collected via nationwide surveys from 263 responding hospitals. Using logistic regression, we examined the relationship between maternal, antepartum, intrapartum, and neonatal risk factors and clinical outcome at 18 months following birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>n <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan, the incidence of moderate or severe <jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content> was 0.37 per 1000 term live births. Outborn births, low <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pgar score at 5\u2009min, use of epinephrine, and low cord blood <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> were intrapartum factors significantly associated with neurodevelopmental delay and death at 18 months. Serum lactate, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase (all, <jats:italic>P<\/jats:italic> &lt; 0.001) and creatine kinase (<jats:italic>P<\/jats:italic> = 0.002) were significantly higher in infants with poor outcome compared to those with favorable outcomes. Abnormal brain magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI)<\/jats:styled-content>, an important prognostic factor, was significantly associated with poor outcome (odds ratio, 11.57; 95% confidence interval: 5.66\u201323.64; <jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Risk factors predicting poor outcome in <jats:styled-content style=\"fixed-case\">HIE<\/jats:styled-content> include outborn birth, low Apgar score at 5\u2009min, use of epinephrine, laboratory abnormalities, and abnormal <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.12233","type":"journal-article","created":{"date-parts":[[2013,10,15]],"date-time":"2013-10-15T15:42:24Z","timestamp":1381851744000},"page":"215-221","source":"Crossref","is-referenced-by-count":46,"title":["Incidence and prediction of outcome in hypoxic\u2013ischemic encephalopathy in <scp>J<\/scp>apan"],"prefix":"10.1111","volume":"56","author":[{"given":"Masahiro","family":"Hayakawa","sequence":"first","affiliation":[{"name":"Division of Neonatology, Center for Maternal\u2013Neonatal Care Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yushi","family":"Ito","sequence":"additional","affiliation":[{"name":"Division of Neonatology Center for Maternal\u2013Fetal and Neonatal Medicine, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toyama  Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Mitsuda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Osaka Medical Center and Research Institute for Maternal and Child Health  Izumi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigeharu","family":"Hosono","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health School of Medicine Nihon University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Yoda","sequence":"additional","affiliation":[{"name":"Department of Neonatology Toho University Omori Medical Center  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutoshi","family":"Cho","sequence":"additional","affiliation":[{"name":"Maternity and Perinatal Center Hokkaido University Hospital  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsufumi","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Showa University Yokohama Northern Hospital  Yokohama 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