Regional population based studies of infants who suffer from intrapartum hypoxia are rare, and Pierrat and colleagues are to be congratulated on such a study. As always it is easy to criticise such studies because case definition is so difficult, and, without accurate imaging and detailed case evaluation, it is difficult to be sure that a neonatal encephalopathy is due to hypoxia. The definition of perinatal hypoxia-ischaemia that they have used might be viewed as inclusive and is at variance with the template for intrapartum causation for cerebral palsy, which …