{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:07:59Z","timestamp":1785499679366,"version":"3.56.0"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,11,1]]},"abstract":"<jats:p>OBJECTIVE. The goals were to identify predictor variables and to develop scoring systems and classification trees to predict death\/disability or death in infants with hypoxic-ischemic encephalopathy.<\/jats:p><jats:p>METHODS. Secondary analysis of data from the multicenter, randomized, controlled, National Institute of Child Health and Human Development Neonatal Research Network trial of hypothermia in hypoxic-ischemic encephalopathy was performed. Data for 205 neonates diagnosed as having hypoxic-ischemic encephalopathy were studied. Logistic regression analysis was performed by using clinical and laboratory variables available within 6 hours of birth, with death or moderate\/severe disability at 18 to 22 months or death as the outcomes. By using the identified variables and odds ratios, scoring systems to predict death\/disability or death were developed, weighting each predictor in proportion to its odds ratio. In addition, classification and regression tree analysis was performed, with recursive partitioning and automatic selection of optimal cutoff points for variables. Correct classification rates for the scoring systems, classification and regression tree models, and early neurologic examination were compared.<\/jats:p><jats:p>RESULTS. Correct classification rates were 78% for death\/disability and 71% for death with the scoring systems, 80% and 77%, respectively, with the classification and regression tree models, and 67% and 73% with severe encephalopathy in early neurologic examination. Correct classification rates were similar in the hypothermia and control groups.<\/jats:p><jats:p>CONCLUSIONS. Among neonates diagnosed as having hypoxic-ischemic encephalopathy, the classification and regression tree model, but not the scoring system, was superior to early neurologic examination in predicting death\/disability. The 3 models were comparable in predicting death. Only a few components of the early neurologic examination were associated with poor outcomes. These scoring systems and classification trees, if validated, may help in assessments of prognosis and may prove useful for risk-stratification of infants with hypoxic-ischemic encephalopathy for clinical trials.<\/jats:p>","DOI":"10.1542\/peds.2006-1591","type":"journal-article","created":{"date-parts":[[2006,11,2]],"date-time":"2006-11-02T18:04:44Z","timestamp":1162490684000},"page":"2084-2093","source":"Crossref","is-referenced-by-count":117,"title":["Predicting Outcomes of Neonates Diagnosed With Hypoxemic-Ischemic Encephalopathy"],"prefix":"10.1542","volume":"118","author":[{"given":"Namasivayam","family":"Ambalavanan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar A.","family":"Carlo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Bann","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Emrich","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary D.","family":"Higgins","sequence":"additional","affiliation":[{"name":"National Institute of Child Health and Human Development Neonatal Research Network, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon E.","family":"Tyson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Michael","family":"O'Shea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Ehrenkranz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald N.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the National Institute of Child Health and Human Development Neonatal Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,11,1]]},"reference":[{"key":"2021120823203571000_R1","unstructured":"Lawn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ.\u20082005;83:409\u2013417"},{"key":"2021120823203571000_R2","doi-asserted-by":"crossref","unstructured":"Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO Child Health Epidemiology Reference Group: WHO estimates of the causes of death in children. Lancet.\u20082005;365:1147\u20131152","DOI":"10.1016\/S0140-6736(05)71877-8"},{"key":"2021120823203571000_R3","doi-asserted-by":"crossref","unstructured":"Shankaran S, Laptook AR, Ehrenkranz RA, et al. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med.\u20082005;353:1574\u20131584","DOI":"10.1056\/NEJMcps050929"},{"key":"2021120823203571000_R4","doi-asserted-by":"crossref","unstructured":"Gluckman PD, Wyatt JS, Azzopardi D, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet.\u20082005;365:663\u2013670","DOI":"10.1016\/S0140-6736(05)70932-6"},{"key":"2021120823203571000_R5","doi-asserted-by":"crossref","unstructured":"Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Arch Neurol.\u20081976;33:696\u2013705","DOI":"10.1001\/archneur.1976.00500100030012"},{"key":"2021120823203571000_R6","doi-asserted-by":"crossref","unstructured":"Robertson CM, Finer NN, Grace MG. School performance of survivors of neonatal encephalopathy associated with birth asphyxia at term. J Pediatr.\u20081989;114:753\u2013760","DOI":"10.1016\/S0022-3476(89)80132-5"},{"key":"2021120823203571000_R7","doi-asserted-by":"crossref","unstructured":"Levene MI, Sands C, Grindulis H, Moore JR. Comparison of two methods of predicting outcome in perinatal asphyxia. Lancet.\u20081986;1:67\u201369","DOI":"10.1016\/S0140-6736(86)90718-X"},{"key":"2021120823203571000_R8","doi-asserted-by":"crossref","unstructured":"Gunn AJ, Gunn TR, Gunning MI, Williams CE, Gluckman PD. Neuroprotection with prolonged head cooling started before postischemic seizures in fetal sheep. Pediatrics.\u20081998;102:1098\u20131106","DOI":"10.1542\/peds.102.5.1098"},{"key":"2021120823203571000_R9","doi-asserted-by":"crossref","unstructured":"Gunn AJ, Gunn TR, de Haan HH, Williams CE, Gluckman PD. Dramatic neuronal rescue with prolonged selective head cooling after ischemia in fetal lambs. J Clin Invest.\u20081997;99:248\u2013256","DOI":"10.1172\/JCI119153"},{"key":"2021120823203571000_R10","doi-asserted-by":"crossref","unstructured":"Gunn AJ, Battin M, Gluckman PD, Gunn TR, Bennet L. Therapeutic hypothermia: from lab to NICU. J Perinat Med.\u20082005;33:340\u2013346","DOI":"10.1515\/JPM.2005.061"},{"key":"2021120823203571000_R11","doi-asserted-by":"crossref","unstructured":"Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993\u20131994. Pediatrics.\u20082000;105:1216\u20131226","DOI":"10.1542\/peds.105.6.1216"},{"key":"2021120823203571000_R12","doi-asserted-by":"crossref","unstructured":"Palisano R, Rossenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol.\u20081997;39:214\u2013223","DOI":"10.1111\/j.1469-8749.1997.tb07414.x"},{"key":"2021120823203571000_R13","unstructured":"Bayley N. Bayley Scales of Infant Development II. San Antonio, TX: Psychological Corp; 1993"},{"key":"2021120823203571000_R14","unstructured":"Brieman L, Friedman JH, Olshen RA, Stone CJ. Classification and Regression Trees. Belmont, CA: Wadsworth; 1984"},{"key":"2021120823203571000_R15","doi-asserted-by":"crossref","unstructured":"Germanson TP, Lanzino G, Kongable GL, Torner JC, Kassell NF. Risk classification after aneurysmal subarachnoid hemorrhage. Surg Neurol.\u20081998;49:155\u2013163","DOI":"10.1016\/S0090-3019(97)00337-6"},{"key":"2021120823203571000_R16","doi-asserted-by":"crossref","unstructured":"Werneck GL, de Carvalho DM, Barroso DE, Cook EF, Walker AM. Classification trees and logistic regression applied to prognostic studies: a comparison using meningococcal disease as an example. J Trop Pediatr.\u20081999;45:248\u2013251","DOI":"10.1093\/tropej\/45.4.248"},{"key":"2021120823203571000_R17","doi-asserted-by":"crossref","unstructured":"Low JA, Galbraith RS, Muir DW, Killen HL, Pater EA, Karchmar EJ. Factors associated with motor and cognitive deficits in children after intrapartum fetal hypoxia. Am J Obstet Gynecol.\u20081984;148:533\u2013539","DOI":"10.1016\/0002-9378(84)90742-7"},{"key":"2021120823203571000_R18","doi-asserted-by":"crossref","unstructured":"Talati AJ, Yang W, Yolton K, Korones SB, Bada HS. Combination of early perinatal factors to identify near-term and term neonates for neuroprotection. J Perinatol.\u20082005;25:245\u2013250","DOI":"10.1038\/sj.jp.7211259"},{"key":"2021120823203571000_R19","doi-asserted-by":"crossref","unstructured":"Toh VC. Early predictors of adverse outcome in term infants with post-asphyxial hypoxic ischaemic encephalopathy. Acta Paediatr.\u20082000;89:343\u2013347","DOI":"10.1111\/j.1651-2227.2000.tb18426.x"},{"key":"2021120823203571000_R20","doi-asserted-by":"crossref","unstructured":"Vannucci RC, Towfighi J, Heitjan DF, Brucklacher RM. Carbon dioxide protects the perinatal brain from hypoxic-ischemic damage: an experimental study in the immature rat. Pediatrics.\u20081995;95:868\u2013874","DOI":"10.1542\/peds.95.6.868"},{"key":"2021120823203571000_R21","doi-asserted-by":"crossref","unstructured":"Ota A, Ikeda T, Abe K, et al. Hypoxic-ischemic tolerance phenomenon observed in neonatal rat brain. Am J Obstet Gynecol.\u20081998;179:1075\u20131078","DOI":"10.1016\/S0002-9378(98)70218-2"},{"key":"2021120823203571000_R22","doi-asserted-by":"crossref","unstructured":"Mallard EC, Williams CE, Gunn AJ, Gunning MI, Gluckman PD. Frequent episodes of brief ischemia sensitize the fetal sheep brain to neuronal loss and induce striatal injury. Pediatr Res.\u20081993;33:61\u201365","DOI":"10.1203\/00006450-199301000-00013"},{"key":"2021120823203571000_R23","doi-asserted-by":"crossref","unstructured":"Morse SB, Haywood JL, Goldenberg RL, Bronstein J, Nelson KG, Carlo WA. Estimation of neonatal outcome and perinatal therapy use. Pediatrics.\u20082000;105:1046\u20131050","DOI":"10.1542\/peds.105.5.1046"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/5\/2084\/1117546\/zpe01106002084.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/5\/2084\/1117546\/zpe01106002084.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T16:33:23Z","timestamp":1683650003000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/118\/5\/2084\/69918\/Predicting-Outcomes-of-Neonates-Diagnosed-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,11,1]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2006,11,1]]},"published-print":{"date-parts":[[2006,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2006-1591","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,11,1]]}}}