{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:03:14Z","timestamp":1791910994364,"version":"4.3.4"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,11,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Neonatal encephalopathy (NE) is a major predictor of death and long-term neurologic disability, but there are few studies of antecedents of NE.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVES:<\/jats:title>\n To identify antecedents in a large registry of infants who had NE.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n This was a maternal and infant record review of 4165 singleton neonates, gestational age of \u226536 weeks, meeting criteria for inclusion in the Vermont Oxford Network Neonatal Encephalopathy Registry.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Clinically recognized seizures were the most prevalent condition (60%); 49% had a 5-minute Apgar score of \u22643 and 18% had a reduced level of consciousness. An abnormal maternal or fetal condition predated labor in 46%; maternal hypertension (16%) or small for gestational age (16%) were the most frequent risk factors. In 8%, birth defects were identified. The most prevalent birth complication was elevated maternal temperature in labor of \u226537.5\u00b0C in 27% of mothers with documented temperatures compared with 2% to 3.2% in controls in population-based studies. Clinical chorioamnionitis, prolonged membrane rupture, and maternal hypothyroidism exceeded rates in published controls. Acute asphyxial indicators were reported in 15% (in 35% if fetal bradycardia included) and inflammatory indicators in 24%. Almost one-half had neither asphyxial nor inflammatory indicators. Although most infants with NE were observably ill since the first minutes of life, only 54% of placentas were submitted for examination.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Clinically recognized asphyxial birth events, indicators of intrauterine exposure to inflammation, fetal growth restriction, and birth defects were each observed in term infants with NE, but much of NE in this large registry remained unexplained.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2012-0714","type":"journal-article","created":{"date-parts":[[2012,10,15]],"date-time":"2012-10-15T21:52:40Z","timestamp":1350337960000},"page":"878-886","source":"Crossref","is-referenced-by-count":113,"title":["Antecedents of Neonatal Encephalopathy in the Vermont Oxford Network Encephalopathy Registry"],"prefix":"10.1542","volume":"130","author":[{"given":"Karin B.","family":"Nelson","sequence":"first","affiliation":[{"name":"Children's Hospital National Medical Center, Washington, District of Columbia;"},{"name":"National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bingham","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika M.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Mathematics and Statistics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Horbar","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Vermont Oxford Network, Burlington, Vermont;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Kenny","sequence":"additional","affiliation":[{"name":"Vermont Oxford Network, Burlington, Vermont;"},{"name":"Medical Biostatistics, University of Vermont, Burlington, Vermont;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrie","family":"Inder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Washington University, St Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Pfister","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Vermont Oxford Network, Burlington, Vermont;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonse","family":"Raju","sequence":"additional","affiliation":[{"name":"National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger F.","family":"Soll","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Vermont Oxford Network, Burlington, 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