Objective To explore the predictive value of early amplitude integrated electroencephalography (aEEG) on neurodevelopmental outcomes in neonates with severe hyperbilirubinemia. Methods A total of 86 neonates with severe hyperbilirubinemia admitted to the neonatal intensive care unit of Enshi Central Hospital from December 2016 to December 2018 were selected as the research subjects.The basic clinical characteristics of the children were recorded.All children underwent aEEG, MRI, or auditory brainstem response (ABR) examination, and were followed up for 12 consecutive months to evaluate the neurodevelopmental outcomes of the children. Results Among the 72 (83.7%) children who were followed up, 16 (22.2%) children had adverse neurodevelopmental outcomes.Compared with children with good neurodevelopmental outcomes, children with poor developmental outcomes had significantly higher total serum bilirubin level, total serum bilirubin/serum albumin ratios, BIND scores>3, and exchange transfusion rates (P<0.05).The results of abnormal aEEG, ABR examinations, and the results of aEEG combined with ABR as well as MRI combined with ABR abnormalities were significantly correlated with adverse neurodevelopmental outcomes in children (P<0.05).Logistic regression analysis showed that aEEG abnormalities (OR=6.898,95%CI:1.047—45.563) and ABR abnormalities (OR=16.998,95%CI:2.685—107.608) were important risk factors for adverse neurodevelopmental outcomes in children.The sensitivity of abnormal aEEG and abnormal ABR to the prediction of neonatal adverse neurodevelopmental outcomes was 56.25% and 85.71%, specificity was 91.07% and 73.33%, accuracy was 83.33% and 77.27%, positive predictive values was 64.29% and 60.00%, and negative predictive value was 87.93% and 91.67%, respectively. Conclusion Early aEEG may predict adverse neurodevelopmental outcomes in neonates with severe hyperbilirubinemia, with higher specificity but lower sensitivity than ABR.
Key words
amplitude integrated electroencephalography /
hyperbilirubinemia /
neurodevelopment /
newborn
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