Antenatal strategies for prevention of neonatal hypoxic-ischemic encephalopathy: potential role of metformin

Key messageNeonatal hypoxic-ischemic encephalopathy remains a major cause of death and lifelong disability despite therapeutic hypothermia.Antenatal maternal neuroprotective strategies remain underexplored; however, recent preclinical findings suggest that metformin may be a low-cost and mechanistically distinct approach.Further studies are warranted to define its optimal timing, efficacy, and maternal-fetal safety.