{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:24:12Z","timestamp":1787826252406,"version":"build-2784847793"},"reference-count":31,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0309_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence and outcome of perinatal asphyxia (PA) in spontaneous extreme preterm birth (PTB) between 24 and 28\u00a0weeks gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0309_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study (2010\u20132019) at a Dutch tertiary center, including singleton spontaneous PTBs with active neonatal management. PA was defined as a 5-min Apgar score\u00a0\u22645, umbilical artery pH\u22647.00, base deficit &gt;12\u202fmmol\/L, and need for ongoing resuscitation. Cases were classified as proven PA (all criteria met), suspected PA (Apgar\u22645 only if blood gas data missing), or no PA. Neurodevelopment was assessed at 2\u00a0years corrected age. Multiple imputation addressed missing data. Logistic regression, adjusted for gestational age (GA), was used to evaluate associations with infant mortality, cerebral injury, and neurodevelopmental impairment (NDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0309_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 138 neonates, 84\u202f% had no PA, 12.3\u202f% suspected PA, and 3.6\u202f% proven PA. After imputation, the estimated incidence of PA was 5.0\u202f%. PA was not significantly associated with infant mortality (aOR 1.07; 95\u202f% CI 0.13\u20138.87; p=0.95) or intraventricular hemorrhage (aOR 1.62; 95\u202f% CI 0.26\u201310.39; p=0.61). NDI occurred in two infants with\u00a0PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0309_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PA occurred more frequently in this extreme preterm cohort than in term neonates, yet did not independently influence mortality or morbidity. A major limitation is the use of ACOG criteria, originally developed for term births, which may have led to over- or underestimation of PA\u2019s true incidence and impact. Although based on few confirmed cases, findings suggest PA, may not be a major independent predictor of adverse outcome in extreme\u00a0PTB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0309","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T16:57:31Z","timestamp":1761670651000},"page":"309-317","source":"Crossref","is-referenced-by-count":1,"title":["The incidence and outcomes of perinatal asphyxia in spontaneous extreme preterm birth: a retrospective cohort study"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-8487","authenticated-orcid":false,"given":"Zohal","family":"Faiz","sequence":"first","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline","family":"van \u2019t Hof","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjon","family":"de Boer","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo R.","family":"de Haan","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Neonatology , Emma Children\u2019s Hospital, Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Weissenbruch","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Neonatology , Emma Children\u2019s Hospital, Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Klautz","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pien","family":"Lippes","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben Willem","family":"Mol","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne","family":"de Groot","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Bakker","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction & Development Research Institute , Amsterdam , The Netherlands"},{"name":"Department of Obstetrics and Gynecology , Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2026051215204226832_j_jpm-2025-0309_ref_001","unstructured":"Rijken, M, van Heijst, AFJ, de Boer, M, Bol, SP, Duvekot, JJ, Evers, A, et al.. 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