Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;120(6):776-788.
doi: 10.1159/000530411. Epub 2023 Aug 3.

Clinical Prediction Models and Predictors for Death or Adverse Neurodevelopmental Outcome in Term Newborns with Hypoxic-Ischemic Encephalopathy: A Systematic Review of the Literature

Juliette F Langeslag  1   2 , Kevin Berendse  3 , Joost G Daams  4 , Wes Onland  3   5 , Mariska M G Leeflang  6 , Anton H van Kaam  3   5 , Timo R de Haan  3   5
Affiliations

Clinical Prediction Models and Predictors for Death or Adverse Neurodevelopmental Outcome in Term Newborns with Hypoxic-Ischemic Encephalopathy: A Systematic Review of the Literature

Juliette F Langeslag et al. Neonatology. 2023.

Abstract

Background: Although many predictive parameters have been studied, an internationally accepted, validated predictive model to predict the clinical outcome of asphyxiated infants suffering from hypoxic-ischemic encephalopathy is currently lacking. The aim of this study was to identify, appraise and summarize available clinical prediction models, and provide an overview of all investigated predictors for the outcome death or neurodevelopmental impairment in this population.

Methods: A systematic literature search was performed in Medline and Embase. Two reviewers independently included eligible studies and extracted data. The quality was assessed using PROBAST for prediction model studies and QUIPS assessment tools for predictor studies.

Results: A total of nine prediction models were included. These models were very heterogeneous in number of predictors assessed, methods of model derivation, and primary outcomes. All studies had a high risk of bias following the PROBAST assessment and low applicability due to complex model presentation. A total of 104 predictor studies were included investigating various predictors, showing tremendous heterogeneity in investigated predictors, timing of predictors, primary outcomes, results, and methodological quality according to QUIPS. Selected high-quality studies with accurate discriminating performance provide clinicians and researchers an evidence map of predictors for prognostication after HIE in newborns.

Conclusion: Given the low methodological quality of the currently published clinical prediction models, implementation into clinical practice is not yet possible. Therefore, there is an urgent need to develop a prediction model which complies with the PROBAST guideline. An overview of potential predictors to include in a prediction model is presented.

Keywords: Asphyxia; Neonatal; Outcome; Prediction; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Flowchart studies. * 2 studies described a prediction model as well as predictors and were included in both groups. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. DOI: 10.1136/bmj.n71. For more information, visit http://www.prisma-statement.org/.
Table 1.
Table 1.
Prediction model studies characteristics
Table 2.
Table 2.
Quality assessment prediction models
Table 3.
Table 3.
Quality assessment predictor studies (QUIPS)
See this image and copyright information in PMC

Comment in

References

    1. Groenendaal F, Casaer A, Dijkman KP, Gavilanes AW, de Haan TR, ter Horst HJ, et al. Introduction of hypothermia for neonates with perinatal asphyxia in The Netherlands and Flanders. Neonatology. 2013;104(1):15–21. 10.1159/000348823. - DOI - PubMed
    1. Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013 Jan 31(1):Cd003311. 10.1002/14651858.cd003311.pub3. - DOI - PMC - PubMed
    1. Bonifacio SL, deVries LS, Groenendaal F. Impact of hypothermia on predictors of poor outcome: how do we decide to redirect care? Semin Fetal Neonatal Med. 2015 Apr;20(2):122–7. 10.1016/j.siny.2014.12.011. - DOI - PMC - PubMed
    1. Douglas-Escobar M, Weiss MD. Hypoxic-ischemic encephalopathy: a review for the clinician. JAMA Pediatr. 2015 Apr;169(4):397–403. 10.1001/jamapediatrics.2014.3269. - DOI - PubMed
    1. Natarajan G, Pappas A, Shankaran S. Outcomes in childhood following therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy (HIE). Semin Perinatol. 2016 Dec;40(8):549–55. 10.1053/j.semperi.2016.09.007. - DOI - PMC - PubMed

Publication types