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This is an invited editorial on the report by Reese et al 1 of the outcome in adolescence among children with neonatal hypoxic-ischaemic encephalopathy (HIE) relative to population controls. The strengths of this study are the length of follow-up and assessment of school performance on a regional cohort of children. The authors found that children with moderate or severe HIE perform at a lower academic level than their peers, but most pass their grade level. Questions remain regarding the unaccounted numbers in (1) and loss to follow-up (supplement 2 and table 3); data are presented on 58% and 61% of children with and without HIE, respectively. It is interesting that the use of hypothermia for moderate or severe HIE increased from 49% to 77% between 2008 and 2013. It is unclear why more infants with moderate or severe HIE did not receive hypothermia, given that it was usual care in most high-income countries at this time.