Injury to the fetal and neonatal brain continues to be a major risk in an era when perinatal care has improved significantly and neonatal survival rates have improved steadily. A great deal of emphasis has been placed on the understanding of the pathophysiological and biochemical alterations that occur during the asphyxial episode or episodes, and which continue through the resuscitative and reparative periods. Newer technologies and approaches to therapy have also been developed to maximize the chances of an optimal outcome for the affected patient. There has been a great deal of effort by the American Academy of Pediatrics and the American Heart Association to educate caretakers in order to improve the immediate and follow-up care of the neurologically depressed newborn who is in need of resuscitative management.

In this, the third edition of our text, we have incorporated many of the newer approaches to the understanding of the cellular and molecular bases of hypoxic–ischemic encephalopathy (HIE) as well as the newer approaches to the immediate and continuing care of these infants. We have added new chapters on obstetrical conditions that may be associated with brain injury of the fetus, including chorioamnionitis, various maternal diseases, and obstetrical catastrophes. Metabolic disorders that may have clinical manifestations that mimic HIE have been emphasized as well. The chapters on infectious diseases that can result in brain injury have been enhanced, with particular reference to viral and group B streptococcal infections.