Annual Reports & Forms

• Neonatal Therapeutic Hypothermia in Ireland Report 2020
• Neonatal Therapeutic Hypothermia in Ireland Report 2019
• Neonatal Therapeutic Hypothermia in Ireland Report 2018
• Neonatal Therapeutic Hypothermia in Ireland Report 2016-2017

Pamphlets

• Neonatal Hypothermia in Ireland Pamphlet

Key Messages from the 2020 Report

• NE is a significant cause of enduring morbidity and is the main cause of mortality in normally formed infants. The total mortality rate for infants in the TH cohort for the time period 2016-2020 was 14%.
• During the years 2016-2020, 357 NE infants were treated with TH, indicating an incidence rate of 1.2 per 1,000 births. Consistent data collection, analysis, action and shared learning is needed to reduce the national incidence of NE requiring TH intervention.
• The antenatal detection of intrauterine growth restriction is important. During the five-year period 2016-2020, approximately 18% of infants who underwent TH were small for dates (birthweight under 10th percentile).
• Over the five year period, 30% of TH infants were born in a peripheral hospital and required transfer to one of the four tertiary centres that deliver TH intervention. The National Neonatal Transport Programme (NNTP) plays an important role in the retrieval of NE infants requiring TH intervention from peripheral hospitals. The data in this report reinforces that the Irish Health Service is providing TH in Ireland by way of a continuum of care between referral hospital, NNTP and tertiary centres.
• The diagnosis of labour can be a challenge.The accurate and consistent application to diagnosing labour is warranted to ensure appropriate level of care and monitoring is provided to mothers and their infants. 
• Nulliparous mothers, induction of nulliparous mothers, shoulder dystocia, ethnicity and obesity with BMI >30 are risk factors for TH which require particular attention in their clinical management.
• Good documentation is the platform for improvement in the assessment, categorisation, and management of infants with NE. Use of the cooling candidacy checklist and daily Sarnat assessment ensures accurate clinical measurement and is is the best pathway to improve outcomes for this group of infants.
• To continue to broaden the understanding of NE and the antecedent factors which contribute to disturbed neurological function it is noted that parity, sentinel events and mode of delivery have a significant role in the causation of NE with first time mothers representing for 60% of cases, sentinel events accounting/contributing to for 36% of cases and events surrounding labour contributing to for 73%.
• The TH report is valuable in that it is wholly representative of the Republic of Ireland thereby eliminating population bias. NE remains a challenging condition, the continued national dataset collection aims to contribute to the improvement in perinatal outcome through the provision of epidemiological evidence.
• Observing outcomes presents the opportunity to measure interventions and benchmark. The mortality rate amongst the TH cohort of infants has been consistent throughout the TH project at 14% over the five-year period.
•  Bayley III outcome data displays that, of the whole cohort (n=85), 29 infants had an impairment and 56 of infants were within normal ranges in all the composite scores (Figure V). Among the infants who had any type of impairment, 41% had an impairment in all the composite scores, 14% in two of them, 28% had an impairment in language composite scores only, and 17% in motor composite scores only (Figure VI).
• Figures I to VI, from the aggregate TH data 2016-2020, are summarised and presented below in terms of parity, sentinel events and mode of delivery to highlight the recurring themes and their incidence. Mortality and outcome data is documented to highlight the life-long implications the effects of NE can have on infants and their families

Lay Information

Lay Glossary 

• Neonatal Therapeutic Hypothermia Lay Glossary

Lay Summaries 

• Neonatal Therapeutic Hypothermia Lay Summary 2020
• Neonatal Therapeutic Hypothermia Lay Summary 2016-2017