The growth and developmental outcomes of Hypoxic Ischemic Encephalopathy; Population-based study from 2010 to 2019

Abstract Despite advances in obstetric care, hypoxic ischemic encephalopathy (HIE) remains a significant disease burden. Using a national dataset, we determined the trends of HIE prevalence, the use of therapeutic hypothermia (TH), mortality, and outcomes from 2012 to 2019. This study included term infants diagnosed with HIE (International Classification of Diseases-10 code: G93.1) between 2012 and 2019 from the National Health Insurance Service database. The prevalence of HIE was 23.7 per 10,000 birth without significant change during the period. The mortality among all term infants with HIE was 4.6% (range: 3.1–6.2%). TH was performed in approximately 6.7% of infants with HIE and the annual variation was large, ranging from 2.4–12.5%. Infants with TH showed significantly higher mortality, nitric oxide usage, and invasive ventilator usage than those without TH. Infants with TH also showed significantly poorer outcomes including delayed development, cerebral palsy (CP), sensorineural hearing loss and seizure compared to infants without TH (p < 0.0001). With increasing application of TH, mortality and developmental outcomes among infants with HIE has been improving in the past eight years in Korea. Further efforts to improve outcomes should be needed.