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This study aims to evaluate the effectiveness and cost-effectiveness of the National PReCePT Programme to increase the uptake of the MgSO4 in English maternity units for the prevention of the cerebral palsy in preterm births via a comparison with the devolved nations (Wales and Scotland), and to investigate whether the improvements in MgSO4 uptake observed in the original evaluation have been sustained over the longer-term.

Outcomes of neonatal encephalopathy (NE) have improved since the widespread implementation of therapeutic hypothermia (TH) in high-resource settings. While TH for NE in term and near-term infants has proven beneficial, 30-50% of infants with moderate-to-severe NE treated with TH still suffer death or significant impairments. There is therefore a critical need to find additional pharmacological and non-pharmacological interventions that improve the outcomes for these children. There are many potential candidates; however, it is unclear whether these interventions have additional benefits when used with TH. Although primary and delayed (secondary) brain injury starting in the latent phase after HI are major contributors to neurodisability, the very late evolving effects of tertiary brain injury likely require different interventions targeting neurorestoration. Clinical trials of seizure management and neuroprotection bundles are needed, in addition to current trials combining erythropoietin, stem cells, and melatonin with TH. IMPACT: The widespread use of therapeutic hypothermia (TH) in the treatment of neonatal encephalopathy (NE) has reduced the associated morbidity and mortality. However, 30-50% of infants with moderate-to-severe NE treated with TH still suffer death or significant impairments. This review details the pathophysiology of NE along with the evidence for the use of TH and other beneficial neuroprotective strategies used in term infants. We also discuss treatment strategies undergoing evaluation at present as potential adjuvant treatments to TH in NE.

Supplemental material, sj-docx-1-bna-10.1177_23982128221097568 for Regulation of glutamate transport and neuroinflammation in a term newborn rat model of hypoxic–ischaemic brain injury by Silvia Pregnolato, Hemmen Sabir, Karen Luyt, Kira DA Rienecker, Anthony R Isles and Elavazhagan Chakkarapani in Brain and Neuroscience Advances

PRISMA-P checklist. (DOCX 16 kb)