Neonatal Hypoxic-Ischemic Encephalopathy and Hypothermia Treatment

( Obstet Gynecol . 2024;143(1):67–81. doi: 10.1097/AOG.0000000000005392) Neonatal hypoxic-ischemic encephalopathy (HIE) is a significant condition linked to mortality and long-term disabilities such as cognitive impairment, cerebral palsy, seizures, and sensory deficits. It falls under neonatal encephalopathy, a broader syndrome characterized by various neurologic dysfunctions, including altered consciousness, respiratory difficulties, and impaired reflexes. This syndrome can arise from multiple causes, including HIE, brain malformations, strokes, genetic disorders, and infections. HIE alone accounts for approximately half of neonatal encephalopathy cases, highlighting its clinical importance due to its association with serious outcomes. HIE can occur suddenly, without warning, and its treatment historically relied on supportive care alone. However, recent research highlights a critical time window in the first hours to days posthypoxia-ischemia, during which hypothermia therapy can mitigate brain injury. This article aims to inform obstetricians about neonatal encephalopathy, particularly HIE, and the role of hypothermia treatment.