ArticlePediatric research2026
Association of early biochemical markers with in-hospital mortality in infants with neonatal encephalopathy.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
backgroundOur aim was to describe the possible association between early, routinely measured serum laboratory parameters and in-hospital mortality in neonates with neonatal encephalopathy (NE), treated with hypothermia.
methodsThis retrospective exploratory cohort study analyzed the results of 19 routinely measured laboratory parameters taken at 6 h of postnatal life from neonates with NE. The primary outcome was defined as in-hospital mortality.
resultsA total of 441 neonates were analyzed, the rate of in-hospital mortality was 12.5%. Multivariable logistic regression analysis (adjusted for 5 min Apgar, initial base excess and Thompson score) showed that for every 1 mmol/L increase in serum phosphate level, the odds of death increased by 8.43-fold (95% CI 3.33-21.39; p = 0.001). ROC analysis demonstrated that a serum phosphate level above 2.58 mmol/L (a threshold remaining within the normal range) provided strong discriminatory potential for in-hospital mortality within this cohort (AUC 0.90; sensitivity 80%, specificity 89%). Among survivors, neurodevelopmental impairment (using the Bayley-II test) was not associated with the initial serum phosphate level.
conclusionOur results suggest that early serum phosphate may be a potential biomarker in the future and may additionally be used to determine the severity and short-term prognosis of neonates with NE. IMPACT: Increased serum phosphate level at six hours of postnatal age was associated with higher odds of in-hospital mortality in infants with neonatal encephalopathy. Unlike for mortality prediction, phosphate was not a significant predictor of neurodevelopmental outcomes. Early serum phosphate may be a potential biomarker in the future and may additionally be used to determine the severity and short-term prognosis of neonates with neonatal encephalopathy.
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