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Hypoxic-Ischemic Encephalopathy MildNCT07393620

Predictive Value of aEEG and Cerebral Oxygenation on Neurological Outcomes in Newborns With Mild Hypoxic-Ischemic Encephalopathy

An observational study of Hypoxic-Ischemic Encephalopathy Mild, run by Uludag University at 3 sites in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Newborns with mild hypoxic-ischemic encephalopathy usually do not receive cooling treatment. However, some of these newborns may develop neurological problems later in life. This observational study aims to evaluate whether early brain monitoring and measurements of brain oxygen levels are associated with neurological… Read more about this study

Who is it for?
Ages 0 to 6 hours
Conditions the study is for
Hypoxic-Ischemic Encephalopathy Mild
How many people
30 participants
Where
3 sitesTurkey (Türkiye)
Study dates
10 Feb 2026to 10 Feb 2029
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 0 to 6 hours
  • All sexes
  • No healthy volunteers
  • Child

Study population: The study population consists of newborns with a gestational age of ≥ 36 0/7 weeks who are diagnosed with mild hypoxic-ischemic encephalopathy within the first 6 hours after birth. Eligible participants include newborns with evidence of an acute peripartum or intrapartum asphyxial event who meet blood gas and clinical criteria for hypoxic-ischemic injury but do not fulfill criteria for moderate or severe encephalopathy or for therapeutic hypothermia at enrollment. Newborns will be prospectively followed from birth up to 24 months of age to assess both short-term and long-term neurological outcomes.

Who may be able to join

  • Gestational age and postnatal age:
  • Gestational age ≥ 36 0/7 weeks and enrollment within the first 6 hours after birth.
  • Blood gas criteria
  • Umbilical cord or postnatal (≤ 1 hour of life) blood gas showing:
  • pH ≤ 7.00 or base deficit ≥ 16 mmol/L
  • OR, if pH is 7.01-7.15 or base deficit is 10-15.9 mmol/L, the presence of both:
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  • An acute perinatal event, and
  • Apgar score ≤ 5 at 10 minutes or ongoing resuscitation at 10 minutes of life, including the need for positive pressure ventilation.
  • ( Evidence of an acute peripartum and intrapartum asphyxia event, defined by at least one of the following: Uterine rupture, placental abruption, umbilical cord prolapse, rupture, tight nuchal cord, maternal hemorrhage, trauma, or cardiopulmonary arrest, vasa previa, category III fetal heart rate tracing, including having either a sinusoidal pattern or absent baseline variability plus recurrent late decelerations, recurrent variable decelerations, or bradycardia.)
  • Clinical evidence of encephalopathy Findings consistent with Sarnat and Sarnat Stage 1 (mild) encephalopathy. Mild, moderate, or severe abnormalities may be present in at least one of the six categories (level of consciousness, spontaneous activity, posture, tone, primitive reflexes [suck and Moro], autonomic nervous system), provided that no more than two categories show moderate or severe findings.

Who cannot join

  • Newborns meeting any of the following criteria will be excluded from the study:
  • Normal neurological examination Newborns with a completely normal neurological examination according to Sarnat and Sarnat staging.
  • Moderate or severe encephalopathy within the first 6 hours of life
  • Clinical findings consistent with moderate or severe encephalopathy during the first 6 hours after birth.
  • Presence of clinical seizures.
  • aEEG findings consistent with moderate or severe encephalopathy requiring therapeutic hypothermia.
Show all 24Show fewer
  • Evidence of electrographic seizure activity on aEEG monitoring.
  • Sarnat and Sarnat criteria for moderate-severe encephalopathy Findings consistent with moderate or severe encephalopathy in three or more Sarnat categories, classified as moderate or severe hypoxic-ischemic encephalopathy.
  • Contraindications to therapeutic hypothermia, including:
  • Evaluation occurring more than 6 hours after birth.
  • Gestational age < 36 weeks or birth weight < 2000 g.
  • Severe or extensive intracranial parenchymal hemorrhage.
  • Severe, life-threatening coagulopathy.
  • Intracerebral infarction.
  • Chromosomal abnormalities (e.g., trisomy 13 or 18) or major congenital anomalies involving multiple organ systems.
  • Lack of parental informed consent
  • Cyanotic congenital heart disease
  • Metabolic encephalopathy Encephalopathy due to metabolic disorders not related to hypoxic-ischemic events.
  • Other conditions associated with encephalopathy unrelated to acute hypoxia
  • Abnormal fetal growth.
  • Maternal infections.
  • Fetomaternal hemorrhage.
  • Severe neonatal sepsis.
  • Chronic placental lesions.

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Salih Çağrı Çakır contact

+90 533 3453739

salihcagri@uludag.edu.tr

Turkey (Türkiye)3 sites, 3 recruiting
  • Bursa City Hospital

    Bursa

    Bayram Ali Dorum, Associate professor, +90 533 7078398, bayramalidorum@gmail.com

    Bayram Ali Dorum, Associate professor

    Recruiting
  • Division of Neonatology, Department of Pediatrics, Bursa Uludağ University Faculty of Medicine

    Bursa

    Salih Çağrı Çakır, +90 533 3453739, salihcagri@uludag.edu.tr

    Nilgün Köksal, Professor

    Recruiting
  • Division of Neonatology, Department of Pediatrics, University of Health Sciences Bursa Yuksek İhtisas Training and Research Hospital

    Bursa

    İpek Güney Varal, Associate professor, +90 532 3413389, ipekguneyvaral@gmail.com

    Gaffari Tunç, Associate professor

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: Predictive Value of Amplitude-Integrated Electroencephalography and Cerebral Tissue Oxygenation on Neurological Outcomes in Neonates With Mild Hypoxic-Ischemic Encephalopathy

Newborns with mild hypoxic-ischemic encephalopathy usually do not receive cooling treatment. However, some of these newborns may develop neurological problems later in life. This observational study aims to evaluate whether early brain monitoring and measurements of brain oxygen levels are associated with neurological outcomes in newborns with mild hypoxic-ischemic encephalopathy. Newborns will be monitored during the first 72 hours after birth as part of routine clinical care. Neurological assessments will be performed during early infancy and later follow-up. The findings of this study may help improve early risk assessment and support closer monitoring of newborns who may be at increased risk for unfavorable neurological outcomes.

Read the detailed description

Perinatal asphyxia resulting from impaired gas exchange may lead to hypoxemia, hypercapnia, and metabolic acidosis, causing injury to the brain and other organs in newborns. Perinatal asphyxia disrupts cerebral autoregulation, leading to primary and secondary energy deficiency, cerebral damage, and hypoxic-ischemic encephalopathy (HIE). HIE remains a significant cause of neonatal mortality and long-term neurological morbidity. HIE is clinically classified as mild, moderate, or severe based on neurological examination findings, most commonly using the Sarnat and Sarnat scoring system. Therapeutic hypothermia has been shown to reduce mortality and morbidity in term and near-term newborns with moderate to severe HIE when initiated within the first 6 hours after birth. However, therapeutic hypothermia is not routinely recommended for newborns with mild HIE due to the lack of sufficient evidence from randomized clinical trials. Although mild HIE is generally associated with a better prognosis, accumulating evidence suggests that a substantial proportion of newborns diagnosed with mild HIE may develop adverse neurodevelopmental outcomes during infancy and early childhood.

Furthermore, the severity of encephalopathy may evolve, and some newborns initially classified as having mild HIE may progress to moderate encephalopathy within the first hours after birth. Early identification of newborns with mild HIE who are at increased risk for neurological deterioration remains challenging, particularly during the critical first 6 hours of life. Continuous bedside brain monitoring techniques may provide valuable prognostic information in this early period. Amplitude-integrated electroencephalography (aEEG) allows continuous assessment of cerebral electrical activity. It helps evaluate the severity of encephalopathy, detect seizures, and predict neurological outcomes in newborns with HIE. Additionally, near-infrared spectroscopy (NIRS) allows for non-invasive monitoring of cerebral oxygenation and cerebral fractional tissue oxygen extraction (cFTOE). However, data regarding the use of NIRS in newborns with mild HIE are limited, particularly during the early postnatal period.

The primary objective of this prospective, multicenter observational cohort study is to investigate the association between early brain monitoring findings and short-term and long-term neurological outcomes in newborns with mild hypoxic-ischemic encephalopathy. Specifically, the study aims to evaluate early neurological findings and neurodevelopmental outcomes up to 24 months of age. Secondarily, this study aims to explore whether early aEEG and NIRS findings may help identify subgroups of newborns with mild HIE who are at higher risk for neurological deterioration and may benefit from closer monitoring and follow-up.

Keywords
Mild Hypoxic Ischemic Encephalopathy, Amplitude-integrated electroencephalography, Cerebral oxygenation, Near infrared spectroscopy, Neonates, aEEG, NIRS

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neurological Outcomes in Neonates with Mild Hypoxic-ischemic Encephalopathy

    The primary outcome measure is the report of neurological outcome in children diagnosed with mild hypoxic-ischemic encephalopathy. Neurological outcome will be measured using the Bayley Scales of Infant and Toddler Development (Bayley-III) at 18-24 months of age; a standard score below 85 in at least one of the cognitive, motor, or language domains will be defined as a neurologic disorder.

    Measured: at 18 and 24 months of age

Secondary outcomes (2)
  1. Correlation Between Early aEEG Background Patterns and Neurological Outcomes in Newborns With Mild Hypoxic-Ischemic Encephalopathy

    This outcome measure evaluates the correlation between:

    1. Continuous amplitude-integrated electroencephalography (aEEG) monitoring will be used within the first 72 hours of life to measure the amplitude (µV) of cerebral electrical activity and to determine background patterns and sleep-wake cycling; and
    2. Neurological outcomes, measured by the Bayley Scales of Infant and Toddler Development (Bayley-III) in the cognitive, motor, and language domains at 18 and 24 months of age.

    Measured: aEEG: within the first 72 hours of life. Neurological outcomes: at 18 and 24 months of age, birth to 24 months of age.

  2. Correlation Between Early Cerebral NIRS Values and Neurological Outcomes in Newborns With Mild Hypoxic-Ischemic Encephalopathy

    This outcome measure evaluates the correlation between:

    1. Early cerebral NIRS values within the first 72 hours of life. Cerebral oxygenation (%) values at NIRS measurements in infants, first 6 h of life, first 24 h of life, between 24-48 h, 48-72 h.
    2. Neurological outcomes, measured by the Bayley Scales of Infant and Toddler Development (Bayley-III) in the cognitive, motor, and language domains at 18 and 24 months of age.

    Measured: Cerebral NIRS: within the first 72 hours of life. Neurological outcomes: at 18 and 24 months of age, birth to 24 months of age.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2026
  2. Study start10 Feb 2026
  3. Primary completion10 Feb 2027 (estimated)
  4. Study completion10 Feb 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07393620
Sponsor's protocol ID
2025/903/17-24
Status last verified
Apr 2026
First submitted
8 Jan 2026
Last updated
1 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: I am not authorized to share patient data.

Publications

  • Shalak LF, Laptook AR, Velaphi SC, Perlman JM. Amplitude-integrated electroencephalography coupled with an early neurologic examination enhances prediction of term infants at risk for persistent encephalopathy. Pediatrics. 2003 Feb;111(2):351-7. doi: 10.1542/peds.111.2.351.

    PubMed 12563063
  • Chalak L. New Horizons in Mild Hypoxic-ischemic Encephalopathy: A Standardized Algorithm to Move past Conundrum of Care. Clin Perinatol. 2022 Mar;49(1):279-294. doi: 10.1016/j.clp.2021.11.016. Epub 2022 Jan 21.

    PubMed 35210007
  • Kariholu U, Montaldo P, Markati T, Lally PJ, Pryce R, Teiserskas J, Liow N, Oliveira V, Soe A, Shankaran S, Thayyil S. Therapeutic hypothermia for mild neonatal encephalopathy: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2020 Mar;105(2):225-228. doi: 10.1136/archdischild-2018-315711. Epub 2018 Dec 19.

    PubMed 30567775
  • Chalak LF, Nguyen KA, Prempunpong C, Heyne R, Thayyil S, Shankaran S, Laptook AR, Rollins N, Pappas A, Koclas L, Shah B, Montaldo P, Techasaensiri B, Sanchez PJ, Sant'Anna G. Prospective research in infants with mild encephalopathy identified in the first six hours of life: neurodevelopmental outcomes at 18-22 months. Pediatr Res. 2018 Dec;84(6):861-868. doi: 10.1038/s41390-018-0174-x. Epub 2018 Sep 13.

    PubMed 30250303
  • Prempunpong C, Chalak LF, Garfinkle J, Shah B, Kalra V, Rollins N, Boyle R, Nguyen KA, Mir I, Pappas A, Montaldo P, Thayyil S, Sanchez PJ, Shankaran S, Laptook AR, Sant'Anna G. Prospective research on infants with mild encephalopathy: the PRIME study. J Perinatol. 2018 Jan;38(1):80-85. doi: 10.1038/jp.2017.164. Epub 2017 Nov 2.

    PubMed 29095433
  • Conway JM, Walsh BH, Boylan GB, Murray DM. Mild hypoxic ischaemic encephalopathy and long term neurodevelopmental outcome - A systematic review. Early Hum Dev. 2018 May;120:80-87. doi: 10.1016/j.earlhumdev.2018.02.007. Epub 2018 Feb 26.

    PubMed 29496329
  • Murray DM, O'Connor CM, Ryan CA, Korotchikova I, Boylan GB. Early EEG Grade and Outcome at 5 Years After Mild Neonatal Hypoxic Ischemic Encephalopathy. Pediatrics. 2016 Oct;138(4):e20160659. doi: 10.1542/peds.2016-0659. Epub 2016 Sep 20.

    PubMed 27650049

Questions about this trial

What is this clinical trial studying?

An observational study of Hypoxic-Ischemic Encephalopathy Mild, run by Uludag University at 3 sites in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 1 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Salih Çağrı Çakır (+90 533 3453739, salihcagri@uludag.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neurological Outcomes in Neonates with Mild Hypoxic-ischemic Encephalopathy (time frame: at 18 and 24 months of age). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07393620, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 May 2026.

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