Multi-organ biomarkers for the identification of neonatal encephalopathy in the absence of traditional fetal acidemia: A three-year clinical cohort study.

Within this group, 49.1% presented with mild, 43.4% with moderate, and 7.5% with severe clinical features, confirming systemic hypoxia despite "normal or near-normal" initial blood gases.

Significant elevations in cardiac Troponin-I and AST were observed in the mild-to-severe classic hypoxic-ischemic encephalopathy groups compared to the non-classic cohort ( p < 0.001).

Troponin-I showed high performance (AUC = 0.711) in predicting moderate-to-severe hypoxic-ischemic encephalopathy across both cohorts.

The NLR was significantly higher in all infants with clinical evidence of moderate-to-severe hypoxic insult.