Joining forces to tackle neonatal encephalopathy

Obstetricians, gynecologists, and pediatricians joined forces to issue a new task force report on identifying the causes of newborn brain injuries. In doing so, they hope to unearth prevention strategies for neonatal encephalopathy, cerebral palsy, and other neurologic problems.

Entitled Neonatal Encephalopathy and Neurologic Outcome, Second Edition, and issued by the Task Force on Neonatal Encephalography of the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, this report recommends, for every case of neonatal encephalopathy, evaluating broadly all factors potentially contributing to the event, including maternal medical history, obstetric and intrapartum factors, and placental pathology, in an effort to find the root cause. This is a big change from the 2003 version, which focused more exclusively on determining whether each case of neonatal encephalopathy is attributable to an intrapartum event.

In fact, this new version specifically states that “if a comprehensive etiologic evaluation is not possible, the term hypoxic–ischemic encephalopathy should best be replaced by neonatal encephalopathy” because neither hypoxia or ischemia can be the unique causal mechanism.

The new report also discusses a new form of treatment-neonatal hypothermia-that cools a newborn to 92.3°F for 72 hours. Research shows that the procedure can minimize long-term brain damage.

The statement also reviews advances made with newborn brain imaging and how scans are now providing much more information about the timing and severity of brain injury. It also emphasizes the involvement of pediatricians in the process of identifying those infants with injuries.

The report took almost 4 years to produce, drawing on experts from the United States and abroad and consulting with thought leaders at the Centers for Disease Control and Prevention, the National Institute of Child Health and Human Development, and numerous other international organizations.

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