{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:18Z","timestamp":1753891938786,"version":"3.41.2"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In Aotearoa New Zealand, the Perinatal &amp;amp; Maternal Mortality Review Committee (PMMRC) collects national data on moderate\/severe neonatal encephalopathy (NE), including demographic and clinical details, such as treatment with therapeutic hypothermia (TH). The Australian and New Zealand Neonatal Network (ANZNN) collects data on infants who receive TH. However, for ANZNN, receipt of TH is the entry criteria, not severity of NE or gestation. As these datasets have different entry criteria, there is potential to combine and gain greater insight into treatment provided nationally for NE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The specific objectives were (1) to compare the NE dataset collected by the PMMRC and the ANZNN cooling dataset from all level 2 and 3 neonatal intensive care units (NICUs) in NZ to understand differences, including the ability to estimate rates of NE over time; (2) to review temporal trends in the provision of TH nationally in NZ over the 9-year period (2010\u20132018), including documenting the number\/year in both datasets and between centre variations; and (3) to assess receipt of TH for NZ infants with moderate to severe NE to ensure it was appropriate and equitable across all groups. The ANZNN dataset is collected in a de-identified manner so analysis was at the aggregate (i.e., total national and\/or tertiary NICU) not individual level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 601 term infants were identified from the PMMRC dataset and 614 term infants from the ANZNN dataset for the study period. The distribution of sex, birth weight, mode of birth, gestation, and plurality were similar between the two datasets. However, there was a difference in the numbers by year of birth. ANZNN demonstrated a trend towards more infants over time consistent with greater use of TH. However, PMMRC demonstrated a stable proportion of infants receiving TH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combined data enabled an estimate to be made of the total NE burden nationally. Moderate and severe NE was documented over the epoch using the consistent PMMRC criteria but the additional ANZNN data illustrated infants cooled outside of moderate to severe NE. The two datasets were definitely not interchangeable for the purpose of NE case ascertainment. There were no major differences demonstrated in the receipt of TH when analysed by ethnicity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1476692","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T05:21:12Z","timestamp":1744694472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal encephalopathy in Aotearoa New Zealand: a review utilising two existing population datasets"],"prefix":"10.3389","volume":"13","author":[{"given":"Malcolm R.","family":"Battin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Sadler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jutta","family":"van den Boom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1001\/archpedi.1991.02160110117034","article-title":"How much of neonatal encephalopathy is due to birth asphyxia?","volume":"145","author":"Nelson","year":"1991","journal-title":"Am J Dis Child"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1038\/s41390-023-02775-z","article-title":"Neonatal encephalopathy and hypoxic-ischemic encephalopathy: moving from controversy to consensus definitions and subclassification","volume":"94","author":"Molloy","year":"2023","journal-title":"Pediatr Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1001\/archneur.1976.00500100030012","article-title":"Neonatal encephalopathy following fetal distress","volume":"33","author":"Sarnat","year":"1976","journal-title":"Arch Neurol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"CD003311","DOI":"10.1002\/14651858.CD003311.pub3","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","volume":"2013","author":"Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"B5","doi-asserted-by":"crossref","first-page":"e1482","DOI":"10.1542\/peds.2014-0724","article-title":"Neonatal encephalopathy and neurologic outcome, second edition","volume":"133","year":"2014","journal-title":"Pediatrics"},{"key":"B6","first-page":"409","article-title":"No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths","volume":"83","author":"Lawn","year":"2005","journal-title":"Bull World Health Organ"},{"key":"B7","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","article-title":"Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the sustainable development goals","volume":"6","author":"Perin","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/pr.2013.206","article-title":"Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990","volume":"74","author":"Lee","year":"2013","journal-title":"Pediatr Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1111\/jpc.14081","article-title":"Neonatal encephalopathy: how can we improve clinical outcomes?","volume":"54","author":"Battin","year":"2018","journal-title":"J Paediatr Child Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/aogs.14296","article-title":"Implementation of a revised classification for intrapartum fetal heart rate monitoring and association to birth outcome: a national cohort study","volume":"101","author":"Jonsson","year":"2022","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B11","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jpeds.2017.04.041","article-title":"Amplitude-integrated electroencephalography improves the identification of infants with encephalopathy for therapeutic hypothermia and predicts neurodevelopmental outcomes at 2 years of age","volume":"187","author":"Skranes","year":"2017","journal-title":"J Pediatr"},{"year":"","key":"B12","article-title":"Fourteenth annual report of the perinatal and maternal mortality review committee"},{"key":"B13","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1111\/jpc.13165","article-title":"Neonatal encephalopathy in New Zealand: demographics and clinical outcome","volume":"52","author":"Battin","year":"2016","journal-title":"J Paediatr Child Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/ajo.13351","article-title":"Shoulder dystocia, umbilical cord blood gases and neonatal encephalopathy","volume":"61","author":"Battin","year":"2021","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/ajo.12957","article-title":"Contributory factors and potentially avoidable neonatal encephalopathy associated with acute peripartum events: an observational study","volume":"59","author":"Sadler","year":"2019","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"747.e1","DOI":"10.1016\/j.ajog.2015.12.037","article-title":"Contributory factors and potentially avoidable neonatal encephalopathy associated with perinatal asphyxia","volume":"214","author":"Sadler","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/S0140-6736(05)17946-X","article-title":"Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial","volume":"365","author":"Gluckman","year":"2005","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1056\/NEJMcps050929","article-title":"Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy","volume":"353","author":"Shankaran","year":"2005","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1001\/archpediatrics.2011.43","article-title":"Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial","volume":"165","author":"Jacobs","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1056\/NEJMoa0900854","article-title":"Moderate hypothermia to treat perinatal asphyxial encephalopathy","volume":"361","author":"Azzopardi","year":"2009","journal-title":"N Engl J Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1177\/0883073819828625","article-title":"Current practice of therapeutic hypothermia for mild hypoxic ischemic encephalopathy","volume":"34","author":"Saw","year":"2019","journal-title":"J Child Neurol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"F388","DOI":"10.1136\/archdischild-2017-313320","article-title":"Therapeutic hypothermia in mild neonatal encephalopathy: a national survey of practice in the UK","volume":"103","author":"Oliveira","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B23","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1055\/s-0040-1716341","article-title":"Utilization of therapeutic hypothermia and neurological injury in neonates with mild hypoxic-ischemic encephalopathy: a report from children\u2019s hospital neonatal consortium","volume":"39","author":"Rao","year":"2022","journal-title":"Am J Perinatol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/jpc.13378","article-title":"Eligibility criteria for therapeutic hypothermia: from trials to clinical practice","volume":"53","author":"Mehta","year":"2017","journal-title":"J Paediatr Child Health"},{"year":"","key":"B25","article-title":"Australian and New Zealand Neonatal Network"},{"key":"B26","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1136\/archdischild-2020-319685","article-title":"Changing clinical characteristics of infants treated for hypoxic-ischaemic encephalopathy in England, Wales and Scotland: a population-based study using the National Neonatal Research Database","volume":"106","author":"Hage","year":"2021","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B27","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1136\/archdischild-2021-322250","article-title":"Neonates with mild hypoxic-ischaemic encephalopathy receiving supportive care versus therapeutic hypothermia in California","volume":"107","author":"Yieh","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"year":"","key":"B28","article-title":"Methods and definitions for perinatal and maternal mortality review committee reporting (2021)"},{"year":"","key":"B29","article-title":"HISO 10001:2017 ethnicity data protocols. Wellington (2017)"},{"key":"B30","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1136\/archdischild-2020-320902","article-title":"Trends in the incidence and management of hypoxic-ischaemic encephalopathy in the therapeutic hypothermia era: a national population study","volume":"106","author":"Shipley","year":"2021","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B31","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.pediatrneurol.2023.08.037","article-title":"Perinatal hypoxic-ischemic encephalopathy: incidence over time within a modern US birth cohort","volume":"149","author":"Cornet","year":"2023","journal-title":"Pediatr Neurol"},{"year":"","key":"B32","article-title":"Therapeutic hypothermia for neonatal encephalopathy\u2014a framework for practice"},{"key":"B33","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1136\/archdischild-2018-315711","article-title":"Therapeutic hypothermia for mild neonatal encephalopathy: a systematic review and meta-analysis","volume":"105","author":"Kariholu","year":"2020","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"year":"","key":"B34","article-title":"Eleventh annual report of the perinatal and maternal mortality review committee: reporting mortality (2015)"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1111\/aogs.14234","article-title":"Hypoxic ischemic encephalopathy in offspring of immigrant women in Sweden: a population-based cohort study","volume":"100","author":"T\u00f6rn","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B36","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1002\/ijgo.13855","article-title":"He Tamariki Kokoti Tau: tackling preterm incidence and outcomes of preterm births by ethnicity in Aotearoa New Zealand 2010\u20132014","volume":"155","author":"Edmonds","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"B37","doi-asserted-by":"publisher","first-page":"17455065221075913","DOI":"10.1177\/17455065221075913","article-title":"Social determinants and inequitable maternal and perinatal outcomes in Aotearoa New Zealand","volume":"18","author":"Dawson","year":"2022","journal-title":"Womens Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1136\/archdischild-2023-326203","article-title":"Recognising risk of neonatal encephalopathy with advancing gestation in nulliparous women is crucial for case review","volume":"109","author":"Battin","year":"2023","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B39","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1111\/ajo.13665","article-title":"Perinatal antecedents of moderate and severe neonatal hypoxic ischaemic encephalopathy: an Australian birth cohort study","volume":"63","author":"Stoke","year":"2023","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ejogrb.2018.06.010","article-title":"Perinatal mortality or severe neonatal encephalopathy among normally formed singleton pregnancies according to obstetric risk status: \u201cis low risk the new high risk?\u201d A population-based cohort study","volume":"228","author":"Joyce","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"4123","DOI":"10.1080\/14767058.2019.1706472","article-title":"Maternal risk factors for adverse outcome in asphyxiated newborns treated with hypothermia: parity and labor duration matter","volume":"34","author":"Xu","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B42","doi-asserted-by":"publisher","first-page":"113966","DOI":"10.1016\/j.jpeds.2024.113966","article-title":"Racial and ethnic inequities in therapeutic hypothermia and neonatal hypoxic-ischemic encephalopathy: a retrospective cohort study","volume":"269","author":"Fall","year":"2024","journal-title":"J Pediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1476692\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T05:21:13Z","timestamp":1744694473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1476692\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,15]]},"references-count":42,"alternative-id":["10.3389\/fped.2025.1476692"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1476692","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2025,4,15]]},"article-number":"1476692"}}