Evidence map›Paper›PMID 41975208›Full record

ArticleJournal of perinatology : official journal of the California Perinatal Association2026

Maternal-placental timing profiles of hypoxic-ischemic insult and association with prognosis in neonatal encephalopathy.

Hannah Bills, Ashley Danguecan, Meredith Kinoshita, Astha Amrit, Emily Lo, Diane Wilson, Emily W Y Tam, Vann Chau, Helen M Branson, Linh G Ly and 3 more

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Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Hannah BillsThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.
Ashley DanguecanThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.
Meredith KinoshitaThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-4291-9037
Astha AmritThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.
Emily LoThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0009-0007-9631-749X
Diane WilsonThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0001-8350-5706
Emily W Y TamDepartment of Paediatrics, University of Toronto, Toronto, ON, Canada.
Vann ChauDepartment of Paediatrics, University of Toronto, Toronto, ON, Canada.
Helen M BransonDepartment of Diagnostic Imaging and Interventional Radiology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Linh G LyThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0001-7709-4752
Amr El ShahedThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-5898-1927
Rhandi ChristensenDepartment of Paediatrics, University of Toronto, Toronto, ON, Canada.
Mehmet N CizmeciThe Hospital for Sick Children, Division of Neonatology, University of Toronto, Toronto, ON, Canada. mehmet.cizmeci@sickkids.ca.ORCID http://orcid.org/0000-0001-6807-4266

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine whether temporal profiles of hypoxic-ischemic insult in neonatal encephalopathy (NE) were associated with outcomes, and to assess their prognostic value. STUDY

designInfants with mild, moderate and severe NE treated with hypothermia were included. Placental histopathology, maternal risk factors, and neonatal clinical, biochemical, electrographic, and neuroimaging data were used to classify infants into proximal, distal, and proximal-on-distal profiles. Neurodevelopmental outcomes were assessed at 18 months.

resultsNinety-eight infants were included (34 distal, 43 proximal, 21 proximal-on-distal). Mortality and composite adverse outcomes were similar between distal-predominant and proximal-predominant groups. Timing of insult profiles was not associated with adverse outcome, whereas the deep gray matter injury subscore independently predicted adverse outcome (aOR 1.36, 95% CI 1.15-1.59; p < 0.001) with an area under the curve of 0.89.

conclusionPerinatal timing of insult profiles did not demonstrate prognostic significance after accounting for NE severity, while MRI-defined injury burden provided the strongest prognostic value. IMPACT: Integrating placental pathology with neonatal neuroimaging provides valuable mechanistic insight but limited prognostic value for outcome prediction across the full spectrum of neonatal encephalopathy due to presumed hypoxic-ischemic encephalopathy. Once neonatal encephalopathy occurs, outcomes are primarily driven by the severity of the hypoxic-ischemic insult. Timing of insult (proximal versus distal) was not associated with mortality, brain injury severity, or neurodevelopmental outcomes in infants with neonatal encephalopathy treated with therapeutic hypothermia.

Indexed as

Hypoxia-Ischemia, BrainPlacentaFemaleHumansHypothermia, InducedInfantInfant, NewbornMagnetic Resonance ImagingMalePregnancyPrognosisRisk FactorsSeverity of Illness IndexTime Factors

Identifiers

PMID41975208

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.