Profile of Neonates Admitted With Hypoxic-Ischemic Encephalopathy and Early Neurodevelopment Outcomes: A Retrospective Cohort Study.

OBJECTIVE: To evaluate contemporary clinical profiles and early neurodevelopmental outcomes of neonates admitted with hypoxic-ischemic encephalopathy (HIE) in an Australian tertiary perinatal unit. STUDY DESIGN: A retrospective cohort study (2019-2025) of neonates born ≥ 35 weeks' gestation admitted with a diagnosis of HIE. Early neurodevelopment outcomes were assessed at 3-4 months corrected age using standardised testing. RESULTS: Of 114 neonates (mean gestation 39 weeks), 35/114 (30.7%) were determined to have mild and 79/114 (69.2%) moderate-to-severe HIE based on overall neonatal course. Comprehensive initial documentation on HIE staging was present in 72/114 (63.2%), with 42/114 (36.8%) requiring retrospective reconstruction of the modified Sarnat score. Therapeutic hypothermia was administered to 27/35 (77.1%) of the mild group, and to 71/79 (89.9%) of the moderate-severe group. Mortality was 16/79 (20.3%) in the moderate-to-severe group and none in the mild group. Abnormal early neurodevelopmental outcomes were observed in 8/27 (29.6%) of the mild and 34/57 (59.6%) of the moderate-to-severe HIE cohort. CONCLUSION: Standardised documentation in HIE remains inconsistent in practice. Given the significant morbidity across all severity stages, this warrants closer scrutiny and reinforcement alongside structured long-term neurodevelopmental surveillance for all affected neonates.