Work

Early Characterization of Hypoxic-Ischemic Encephalopathy: Contribution of Biochemical, Imaging, and Electrophysiological Markers to Patient Profiling in the Ancillary Cohort LyTONEPAL

Year: 2026

Type: article

Abstract: BACKGROUND: To identify and characterize different profiles of newborns with hypoxic-ischemic encephalopathy (HIE) according to clinical, biochemical, electrophysiological, and brain imaging data. METHODS: An analysis was conducted on the Long-Term Outcome of Neonatal hypoxic EncePhALopathy in the era of neuroprotective treatment with hypothermia ancillary cohort, including 204 newborns with mild to severe HIE. Multiple factor analysis and hierarchical ascendant classification were performed using clinical, biochemical, electrophysiological, and imaging data to establish clusters representing the cohort. RESULTS: The combination of electrophysiological, biochemical, and imaging data provided the best representation of the ancillary cohort, accounting for 36.5% of the explained variance. Two clusters of patients were identified using these factors. Patients allocated to cluster 2 were more likely to present severe HIE (70.8%; P < 0.001), severe electroencephalograph patterns (65.2%; P < 0.001), brain injuries (66.3%; P < 0.001) and biochemical abnormalities in pH (6.91 ± 0.18; P < 0.05), lactate levels (14.7 ± 5.5; P < 0.001), and glycemia (P < 0.05). By contrast, cluster 1 was predominantly represented by neonates with mild HIE symptoms, better electroencephalograph patterns, biochemical markers, and no brain lesions. There were no significant differences in maternal and obstetrical data, particularly sentinel events, between the clusters. CONCLUSIONS: Early consideration of the association of biochemical, electrophysiological, and brain imaging data in neonates with HIE would allow a better and more precise characterization of the HIE profile of the newborn and its severity, compared to the sole clinical evaluation through Sarnat or Thompson score in this population.

Source: Pediatric Neurology

DOI: 10.1016/j.pediatrneurol.2026.10.001