• ≥ 36 weeks gestation.

• Sentinel event prior to delivery such as abruption, tight nuchal cord, uterine rupture, profound bradycardia, shoulder dystocia, or cord prolapse or other acute event likely attributable for newborn depression at delivery or an acute change in the fetal status with a clinical presentation consistent with an acute sentinel event with no clearly defined etiology.

• Moderate or severe encephalopathy based on at least one risk of encephalopathy criterion (a) and one clinical signs of encephalopathy criterion (b):

‣ Risk of encephalopathy (either):

• Blood gas drawn within 1 hour of birth, either arterial blood gas (ABG) or venous blood gas (VBG) (cord or infant) with pH ≤ 7.0 OR base deficit ≥ 16 mmol/L.

‣ OR

∙ appearance, pulse, grimace, activity, and respiration (APGAR) score ≤ 5 at 10 minutes OR

∙ The infant required assisted ventilation ≥ 10 minutes after birth (ie, endotracheal, mask ventilation, or continuous positive airway pressure \[CPAP\]).

⁃ Clinical signs of encephalopathy (either/both):

• Moderate/Severe encephalopathy on National Institute of Child Health and Human Development assessment.

∙ Evidence of seizures (clinical and/or electroencephalogram).

• Be eligible to receive therapeutic hypothermia.

• Active whole-body cooling to be started prior to 6 hours of age (passive cooling is permitted prior to active whole body cooling).

• Product of a singleton pregnancy.

• Written informed consent obtained from parent or legal guardian.