Comparison of YASHMA and Thompson scores for predicting short-term outcomes in neonates with hypoxic-ischemic encephalopathy

Perinatal asphyxia occurs as a result of disruption in placental blood flow or gas exchange immediately before, during, or shortly after birth. Consequently, several scoring systems have been developed to to assess disease severity and predict prognosis in affected infants. The aim of this study was to compare the Thompson score and the Yieldly and Scorable Holistic Measuring of Asphyxia (YASHMA) score in predicting short-term prognosis in neonates with hypoxic-ischemic encephalopathy ( HIE). This retrospective observational study included 80 infants admitted to the neonatal intensive care unit (NICU) with a diagnosis of HIE between January 1, 2024, and December 31, 2025. Infants were classified according to the Sarnat&Sarnat classification. The study population was divided into the groups—mild-HIE and moderate-to-severe HIE—and the data were compared between groups. A total of 80 neonates with HIE were evaluated, including 37 with mild and 43 with moderate-to-severe HIE. Gestational age was similar between groups, whereas birth weight was significantly lower in the moderate-to-severe group. These infants also had significantly lower Apgar scores, higher cesarean delivery rates, more abnormal aEEG patterns, and longer hospital stays. Thompson and YASHMA scores were significantly higher and strongly correlated. Metabolic markers indicated more severe acidosis and higher lactate, LDH, and troponin levels in moderate-to-severe HIE. Both scores demonstrated excellent diagnostic performance in identifying disease severity and predicting short-term clinical outcomes. Although the Thompson score showed numerically higher diagnostic accuracy, the overall performance of the two scoring systems was comparable. Both the Thompson and YASHMA scoring systems are effective tools for assessing disease severity and predicting short-term outcomes in newborns with HIE. While both the Thompson and YASHMA scores demonstrated comparable overall diagnostic and prognostic performance, the Thompson score showed numerically higher diagnostic accuracy, whereas the YASHMA score provided a more balanced sensitivity–specificity profile and may serve as a complementary tool in clinical practice.