#AI reads Urine# Urinary metabolome at birth in patients with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and long-term neurodevelopmental outcomes
Published 30 December, 2025
This study focuses on neonates with hypoxic-ischemic encephalopathy (HIE) who received therapeutic hypothermia, aiming to explore whether the metabolome in their urine at birth can predict long-term neurodevelopmental outcomes and to evaluate the predictive value of early brain magnetic resonance imaging (MRI). The study enrolled 53 such neonates and followed them up for 4 to 7 years (with a maximum follow-up period of 7 years). Eventually, a complete set of follow-up results was obtained for 40 neonates, who were divided into two groups: the adverse outcome (AO) group (11 cases, including perinatal death, cerebral palsy, or an intelligence quotient (IQ) below 70) and the favourable outcome (FO) group (29 cases, without cerebral palsy and with an IQ of 70 or above). To reduce bias, 11 neonates were selected from the FO group whose perinatal characteristics (such as gestational age and birth weight) matched those of the neonates in the AO group for in-depth analysis.
By testing the urine samples of these neonates during therapeutic hypothermia, 21 metabolites that could distinguish between the two groups were identified, among which 5 metabolites (glycolic acid, γ-butyrolactone, N-acetyl-galactosamine/glucosamine, aldosterone, and creatinine) exhibited independent discriminative ability. These metabolites are associated with neuroprotection and cell survival. Meanwhile, it was found that the positive predictive value of early brain MRI for adverse outcomes was 67%, and the negative predictive value for favourable outcomes was 96%.
As the current study with the longest follow-up period of its kind, it is the first to establish a link between the urinary metabolome of neonates at birth and their long-term neurodevelopmental outcomes, providing potential biomarkers for predicting the risk of long-term neurodevelopmental issues in neonates with HIE. In the future, the combination of metabolite detection, MRI, and electroencephalography may improve the accuracy of prediction. However, the study has limitations, such as a small sample size, no comparison of metabolites in blood, and a single method for IQ assessment, which require further verification in subsequent research.
J Transl Med. 2025 Nov 24;23(1):1345. doi: 10.1186/s12967-025-06714-w.
Youhe Gao
Statement: During the preparation of this work the author(s) used Doubao / AI reading for summarizing the content. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.
For earlier AI Reads Urine articles：