{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:36:51Z","timestamp":1792417011067,"version":"4.4.0"},"reference-count":18,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000276","name":"Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2017,9,19]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>In 2015, the Department of Health in England announced an ambition to reduce \u2018brain injuries occurring during or soon after birth\u2019. We describe the development of a pragmatic case definition and present annual incidence rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study using data held in the National Neonatal Research Database (NNRD) extracted from neonatal electronic patient records from all National Health Service (NHS) neonatal units in England, Wales and Scotland. In 2010\u20132011, population coverage in the NNRD was incomplete, hence rate estimates are presented as a range; from 2012, population coverage is complete, and rates (95% CIs) are presented. Rates are per 1000 live births.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>NHS neonatal units in England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>Infants admitted for neonatal care; denominator: live births in England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measure<\/jats:title>\n                  <jats:p>\u2018Brain injuries occurring at or soon after birth\u2019 defined as infants with seizures, hypoxic-ischaemic encephalopathy, stroke, intracranial haemorrhage, central nervous system infection and kernicterus and preterm infants with cystic periventricular leucomalacia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2010, the lower estimate of the rate of \u2018Brain injuries occurring at or soon after birth\u2019 in England was 4.53 and the upper estimate was 5.19; in 2015, the rate was 5.14 (4.97, 5.32). For preterm infants, the population incidence in 2015 was 25.88 (24.51, 27.33) and 3.47 (3.33, 3.62) for term infants. Hypoxic-ischaemic encephalopathy was the largest contributor to term brain injury, and intraventricular\/periventricular haemorrhage was the largest contributor to preterm brain injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Annual incidence rates for brain injuries can be estimated from data held in the NNRD; rates for individual conditions are consistent with published rates. Routinely recorded clinical data can be used for national surveillance, offering efficiencies over traditional approaches.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2017-313707","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T12:19:14Z","timestamp":1508761154000},"page":"F301-F306","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":152,"title":["Neonatal brain injuries in England: population-based incidence derived from routinely recorded clinical data held in the National Neonatal Research Database"],"prefix":"10.1136","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-876X","authenticated-orcid":false,"given":"Chris","family":"Gale","sequence":"first","affiliation":[{"name":"Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yevgeniy","family":"Statnikov","sequence":"additional","affiliation":[{"name":"Society and College of Radiographers, London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sena","family":"Jawad","sequence":"additional","affiliation":[{"name":"Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabita N","family":"Uthaya","sequence":"additional","affiliation":[{"name":"Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Modi","sequence":"additional","affiliation":[{"name":"Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,22]]},"reference":[{"key":"2025090502142503000_103.4.F301.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041996"},{"key":"2025090502142503000_103.4.F301.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31593-8"},{"key":"2025090502142503000_103.4.F301.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0278"},{"key":"2025090502142503000_103.4.F301.4","unstructured":"HealthDo. New ambition to halve rate of stillbirths and infant deaths. 2015 https:\/\/www.gov.uk\/government\/news\/new-ambition-to-halve-rate-of-stillbirths-and-infant-deaths (accessed 7 Mar 2017)."},{"key":"2025090502142503000_103.4.F301.5","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-312010"},{"key":"2025090502142503000_103.4.F301.6","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-309928"},{"key":"2025090502142503000_103.4.F301.7","unstructured":"ONS. Office for national statistics: birth summary tables-England and Wales, 2016. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/livebirths\/datasets\/birthsummarytables (accessed 20 Feb 2017)."},{"key":"2025090502142503000_103.4.F301.8","unstructured":"ONS. Office for National statistics: tables on births and infant deaths, by gestation, England only; 2013-2014, 2016. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/livebirths\/adhocs\/005290tablesonbirthsandinfantdeathsbygestationenglandonly (accessed 6 Jun 2017)."},{"key":"2025090502142503000_103.4.F301.9","unstructured":"ONS. Office for National Statistics: live births and stillbirths by gestation, birthweight, multiplicity and region. Infant deaths by gestation birthweight, multiplicity, region and cause group, England 2015. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/stillbirths\/adhocs\/006942livebirthsandstillbirthsbygestationbirthweightmultiplicityandregioninfantdeathsbygestationbirthweightmultiplicityregionandcausegroupengland2015 (accessed 15 Jun 2017)."},{"key":"2025090502142503000_103.4.F301.10","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.206"},{"key":"2025090502142503000_103.4.F301.11","doi-asserted-by":"publisher","DOI":"10.1007\/BF00262235"},{"key":"2025090502142503000_103.4.F301.12","doi-asserted-by":"crossref","unstructured":"Chevallier M , Debillon T , Pierrat V , et al . Leading causes of preterm delivery as risk factors for intraventricular hemorrhage in very preterm infants: results of the EPIPAGE 2 cohort study. 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