This study utilizes the Web of Science Core Collection as its primary data source, a reputable digital database highly regarded for bibliometric analysis (29, 30). Data collection for the study was conducted on June 6, 2024, referencing Figure 1 and Table 1 to search for both articles and review articles on NE. This search also included meta-analyses and systematic reviews. Employing search terms such as “neonatal encephalopathy”, “asphyxia neonatorum”, “birth asphyxia”, “perinatal asphyxia”, and “hypoxic-ischaemic encephalopathy” within the advanced search interface, we targeted English articles and reviews published between January 1, 2005, and May 31, 2024. The search specifically focused on articles and reviews within the field of pediatrics. Initially, 3,361 potentially relevant articles were identified. However, the compilation of literature may include content that appears pertinent but is actually unrelated. Therefore, to ensure that the literature examined closely aligns with the research topic, a manual screening process is often necessary following the initial search. During this initial phase, materials deemed irrelevant are excluded based on their titles and abstracts, necessitating the involvement of two members of the research team. Subsequently, a detailed review of the complete texts is conducted to accurately identify the essential literature for the study. To execute the second stage of manual screening systematically and impartially, any disagreements among the researchers are resolved through discussion. After a thorough screening process and the elimination of irrelevant literature, a total of 893 documents were identified as suitable for further exploration in relevant fields.

CiteSpace, a software tool renowned for visualizing knowledge graphs and analyzing data, provides researchers with insights into network patterns, subject area growth, and citation prominence, thereby elucidating trends in academic research. Meanwhile, VOSviewer, extensively used in library and information sciences, facilitates the visual analysis of literature across various fields. Its subject neutrality and user-friendly interface, combined with a suite of functionalities and advanced visualization features, make it a preferred tool for scholars. VOSviewer (version 1.6.20) enables data manipulation and analysis through label view, density view, cluster density view, and scatter view. In this study, we employed VOSviewer and CiteSpace (version 6.2.R4) to import publications for analysis, examining elements such as titles, keywords, authors, institutions, countries, journals, publication years, citations, average citations, and cited references. The bibliometric data were subsequently exported to Microsoft Excel 2016 to identify publication patterns, document type distribution, and to assess the impact of primary contributors, including authors, institutions, countries, and journals. VOSviewer generated visual representations of connections among these entities, highlighting their scientific influence. Additionally, VOSviewer was used to map co-occurring author keywords, while CiteSpace charted key cited terms, revealing the evolution of knowledge, emerging themes, and potential research frontiers. In the visual map generated by VOSviewer, node colors denote groupings, sizes indicate publication or keyword frequency, links signify collaboration or co-occurrence, and link widths represent strength.

The study examined 893 papers authored by 3,651 individuals affiliated with 1,178 institutions across 68 countries. These papers were published in 67 journals and referenced a total of 15,553 sources from 3,257 distinct journals. The publication period spanned from 2005 to 2024, as illustrated in Figure 2. The dataset comprised 754 articles and 139 reviews, all sourced from public databases and free of any medical ethics concerns.

Locat's theorem suggests that around half of the papers in a given field are authored by a highly productive group of individuals (16). This group typically consists of a number of authors equal to approximately the square root of the total number of authors in the field. To determine the minimum number of publications for a core author, one can calculate the square root of the most prolific author's publications and multiply it by 0.749. In this particular field, core authors are expected to have a minimum of 4 publications, with a total of 208 core authors identified. The top five authors, who collectively contributed to 141 papers, represent roughly 15.78% of all publications in the field. Figure 3 illustrates a network visualization depicting collaborative connections among authors. The thickness of the lines signifies the strength of these connections, while the size of the circles denotes the number of articles published by each author. The nodes’ sizes correspond to the number of citations received, and the connecting lines not only link the nodes but also indicate shared reference relationships. The proximity of nodes in the visualization indicates the level of association among authors, often resulting in the formation of distinct clusters. This visualization technique is crucial for aiding researchers in comprehending collaboration and citation relationships, thereby enhancing understanding of academic interactions and partnerships within the scholarly community. Additionally, it offers a unique and user-friendly approach to analyzing intricate relationships within academia. Table 2 highlights the top 5 most influential authors.

Seetha Shankaran has published 41 articles, which have garnered a total of 2,008 citations. Her most cited paper, “Childhood Outcomes After Hypothermia for Neonatal Encephalopathy” (2012), has received 307 citations and examines the effects of therapeutic hypothermia on newborns with hypoxic-ischemic encephalopathy (31). Additionally, her research explores various topics, including brain injury assessment and the long-term outcomes of neonatal encephalopathy (31–33). The majority of her work focuses on the treatment and prognosis of NE, particularly through the application of therapeutic hypothermia (34–36).

Floris Groenendaal is the author of 26 articles, which have collectively received a total of 974 citations. His research emphasizes the importance of imaging assessments in the context of perinatal asphyxia, along with the treatments associated with this condition (37, 38). One notable paper, titled “MR Imaging and Outcome of Term Neonates with Perinatal Asphyxia: Value of Diffusion-Weighted MR Imaging and ¹H MR Spectroscopy” (2011), has been cited 51 times. This study investigates the relationship between MR imaging and the outcomes of term neonates affected by perinatal asphyxia (39).

Linda S. de Vries has authored 25 articles that have collectively garnered a total of 1,561 citations. Her most cited paper, “Origin and Timing of Brain Lesions in Term Infants with Neonatal Encephalopathy”, has received 144 citations and investigates the causes of neonatal encephalopathy (40). Her research primarily focuses on the assessment of hypothermia in neonatal encephalopathy, the application of imaging techniques in this context, and the perinatal risk factors associated with NE (41–43). Pia Wintermark's research focuses on the incidence and outcomes of neonatal acute kidney injury, the analysis of placental pathology in asphyxiated newborns who are candidates for therapeutic hypothermia, and the utilization of MRI in asphyxiated newborns receiving hypothermia treatment (44–46). One of her prominent works is titled “Placental Pathology in Asphyxiated Newborns Meeting the Criteria for Therapeutic Hypothermia” (2010), which has been cited 42 times (45).

Marianne Thoresen, a distinguished researcher in neonatal medicine, has authored 23 articles that have collectively garnered 1,441 citations. Among her contributions, the study titled “Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial” stands out, with 656 citations (47). This research investigates the efficacy of head cooling in conjunction with mild systemic hypothermia as a treatment for neonatal encephalopathy, illuminating its potential as an intervention for this condition (47). Additionally, Thoresen's work explores the application of moderate hypothermia in managing perinatal asphyxial encephalopathy, providing valuable insights into the therapeutic options available for this disorder (41, 48, 49). Overall, her studies significantly enhance our understanding of the impact of hypothermia on outcomes in cases of NE and perinatal asphyxial encephalopathy, underscoring her expertise in this crucial area of neonatal healthcare (50, 51).

The analysis indicates that research in this field has received contributions from 68 countries, with the United States being the most prolific in terms of publications. The United Kingdom, Canada, the Netherlands, and the Republic of Ireland closely follow in publication numbers. Figure 4 visually represents the collaborative network among these nations, highlighting the top five most influential countries as detailed in Table 3.

According to Table 4, the University of Washington has the highest publication count on Neonatal Encephalopathy, with a total of 64 papers. Following closely are Wayne State University with 49 articles and Stanford University with 40 articles. Among the top 10 institutions, University of California, San Francisco leads in citation count, with 3,237 citations, followed by University of Washington, with 3,152 citations, and the University of Bristol with 2,464 citations.

The underlying assumption of co-occurrence analysis is that words that frequently appear together possess thematic connections. VOSviewer visually represents strong relationships between terms by creating distance-based maps, where shorter distances indicate stronger connections. Lines on the map illustrate relationships between items, with more prominent items regarded as more significant within the studied context. Our analysis using VOSviewer concentrated on keywords, as depicted in Figure 5. The clusters, represented in different colors, signify groups of keywords, with node size reflecting their frequency of occurrence. The top ten keywords identified were “Hypoxic-ischemic encephalopathy”, “Neonatal encephalopathy”, “Therapeutic hypothermia”, “Perinatal asphyxia”, “Infants”, “Whole-body hypothermia”, “Hypothermia”, “Brain injury”, “Newborns” and “Outcomes”. Figure 6 presents the bibliographic coupling in an overlay view for articles published from 2005 to 2024, where item size corresponds to the number of citations. Figure 7 illustrates the density map of keywords.

Table 5 presents the top ten journals with the highest number of articles on neonatal encephalopathy, with Pediatric Research leading the list by publishing 70 articles. The impact factor serves as a numerical indicator for evaluating a journal's citation rate; notably, Pediatrics boasts the highest impact factor at 6.2, while both the Journal of Pediatrics and the Archives of Disease in Childhood - Fetal and Neonatal Edition each have impact factors of 3.9. By examining co-cited works, researchers can establish a foundational knowledge base for a particular area of study. The forefront of research consists of a selection of referenced publications that contribute to these knowledge foundations. Figure 8 illustrates the connectivity of co-citation among various journals.