Researchers hope that adopting an internationally recognised definition for neonatal encephalopathy will improve research into the condition
A global team led by Irish researchers has produced the first agreed definition of a serious condition affecting the brains of newborn babies.
Between one and four infants in every 1,000 births develop neonatal encephalopathy, a neurological syndrome characterized by a reduced level of consciousness, seizures, abnormal reflexes, and breathing difficulties.
The condition carries a high risk of mortality or disability, including cerebral palsy. However, doctors and researchers have long used a range of terms – including hypoxic-ischaemic encephalopathy and perinatal asphyxia – to describe the condition, leading to varying definitions being applied.
Following an extensive international consultation with clinicians, researchers and families from 52 countries, researchers at Trinity College Dublin, the Coombe Hospital, and the Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE) have now published an agreed definition of the syndrome.
The researchers hope that adopting a single, internationally recognised definition will improve the design of clinical trials and facilitate more accurate investigations into the causes of newborn brain injury.
“When doctors and researchers use different terms to describe the same condition, it can create confusion for families and impede scientific progress,” said senior author Prof Eleanor Molloy.
“This new definition provides a common language that will improve communication, support research and ultimately contribute to better care for babies and their families.”
The new consensus definition involved 378 participants worldwide. It defines neonatal encephalopathy as a heterogeneous clinical condition characterised by abnormal or impaired brain function with multiple potential causes. It recognises that the condition can arise from a range of factors, including oxygen deprivation, infection, stroke, genetic disorders and metabolic disease.
Previous descriptions of the condition focused largely on babies eligible for cooling therapy after oxygen-related injury. This new definition encompasses all infants with neonatal encephalopathy, regardless of gestational age, severity or underlying cause.
“For decades there has been debate over how to define neonatal encephalopathy,” said lead author Dr Aoife Branagan.
“Reaching international agreement is a crucial first step towards improving diagnosis, developing new treatments and ensuring that families receive clearer explanations about their child’s condition and prognosis.”
The research team now plan to establish internationally agreed diagnostic criteria for neonatal encephalopathy, and further refine the terminology surrounding related conditions such as hypoxic-ischaemic encephalopathy and perinatal asphyxia.
Read the study: Defining neonatal encephalopathy: an international real-time Delphi consensus process – The Lancet Child and Adolescent Health.