{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:11:17Z","timestamp":1791803477670,"version":"4.3.4"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, approximately 9 million neonates develop perinatal asphyxia annually of which about 1.2 million die. Majority of the morbidity and mortality occur in Low and middle-income countries. However, little is known about the current trend in incidence, and the factors affecting mortality from hypoxic ischaemic encephalopathy (HIE), in Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We assessed the trends in incidence and fatality rates and evaluated the predictors of mortality among babies admitted with HIE over five years at the Lagos University Teaching Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A temporal trend analysis and retrospective cohort study of HIE affected babies admitted to the neonatal unit of a Nigerian Teaching Hospital was conducted. The socio-demographic and clinical characteristics of the babies and their mothers were extracted from the neonatal unit records. Kaplan-Meir plots and Multivariable Cox proportional hazard ratio was used to evaluate the survival experienced using Stata version 16 (StataCorp USA) statistical software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age of the newborns at admission was 26.5 (10\u201353.5) hours and the male to female ratio was 2.1:1. About one-fifth (20.8%) and nearly half (47.8%) were admitted within 6 hours and 24 hours of life respectively, while majority (84%) of the infants were out-born. The prevalence and fatality rate of HIE in our study was 7.1% and 25.3% respectively. The annual incidence of HIE among the hospital admissions declined by 1.4% per annum while the annual fatality rate increased by 10.3% per annum from 2015 to 2019. About 15.7% died within 24 hours of admission. The hazard of death was related to the severity of HIE (p = 0.001), antenatal booking status of the mother (p = 0.01) and place of delivery (p = 0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The case fatality rate of HIE is high and increasing at our centre and mainly driven by the pattern of admission of HIE cases among outborn babies. Thus, community level interventions including skilled birth attendants at delivery, newborn resuscitation trainings for healthcare personnel and capacity building for specialized care should be intensified to reduce the burden of HIE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0250633","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T13:54:54Z","timestamp":1619445294000},"page":"e0250633","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Trends and predictors of in-hospital mortality among babies with hypoxic ischaemic encephalopathy at a tertiary hospital in Nigeria: A retrospective cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-3211","authenticated-orcid":true,"given":"Beatrice Nkolika","family":"Ezenwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6634-8550","authenticated-orcid":true,"given":"Gbenga","family":"Olorunfemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iretiola","family":"Fajolu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyin","family":"Adeniyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadijah","family":"Oleolo-Ayodeji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blessing","family":"Kene-Udemezue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Olamijulo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinyere","family":"Ezeaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"issue":"4","key":"pone.0250633.ref001","doi-asserted-by":"crossref","first-page":"101140","DOI":"10.1016\/j.siny.2020.101140","article-title":"Evaluation for the etiology of neonatal encephalopathy and the diagnosis of FIRS","volume":"25","author":"TE Wiswell","year":"2020","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"key":"pone.0250633.ref002","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1478-4505-5-4","article-title":"Reducing one million child deaths from birth asphyxia: a survey of health systems gaps and priorities","volume":"5","author":"JE Lawn","year":"2007","journal-title":"Health Res Policy Syst"},{"issue":"2","key":"pone.0250633.ref003","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4103\/tjmr.tjmr_42_16","article-title":"Prevalence and outcome of perinatal asphyxia: Ouraexperience in a semi\u2014urban setting","volume":"20","author":"I Aliyu","year":"2017","journal-title":"Tropical journal of Medical Research"},{"key":"pone.0250633.ref004","doi-asserted-by":"crossref","first-page":"4367248","DOI":"10.1155\/2020\/4367248","article-title":"Prevalence and Associated Factors of Perinatal Asphyxia in Neonates Admitted to Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A Cross-Sectional Study","volume":"2020","author":"GT Gebregziabher","year":"2020","journal-title":"Int J Pediatr"},{"key":"pone.0250633.ref005","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40748-018-0074-4","article-title":"Incidence and short term outcomes of neonates with hypoxic ischemic encephalopathy in a Peri Urban teaching hospital, Uganda: a prospective cohort study","volume":"4","author":"H Namusoke","year":"2018","journal-title":"Matern Health, Neonatol and Perinatol"},{"issue":"5","key":"pone.0250633.ref006","first-page":"140","article-title":"Incidence of Birth Asphyxia as seen in Central Hospital and GN Children\u2019s Clinic both in Warri Niger Delta of Nigeria: An Eight Year Retrospective Review","volume":"4","author":"GI Mcgil Ugwu","year":"2012","journal-title":"Glob J Health Sci"},{"key":"pone.0250633.ref007","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/apa.14821","article-title":"Systematic review: long\u2010term cognitive and behavioural outcomes of neonatal hypoxic\u2013ischaemic encephalopathy in children without cerebral palsy","volume":"109","author":"M Schreglmann","year":"2020","journal-title":"Acta Paediatr"},{"key":"pone.0250633.ref008","unstructured":"Zulfiqar A. 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