Early Amplitude-Integrated Electroencephalography Predicts Long-Term Outcomes in Term and Near-Term Newborns With Severe Hyperbilirubinemia

• Background: We aimed to determine the predictive neurological prognostic value of early amplitude-integrated electroencephalography (aEEG) in term and near-term neonates with severe hyperbilirubinemia compared with cranial magnetic resonance imaging (MRI) and auditory brainstem response (ABR). Methods: Infants of >= 35 weeks of gestation with severe hyperbilirubinemia (total serum bilirubin [TSB] 340 mu mol/L) or with hyperbilirubinemia (TSB >= 257 mu mol/L) in association with bilirubin-induced neurological dysfunction were recruited. All the subjects had an aEEG after being admitted to the neonatal intensive care unit, whereas cranial MRI and ABR were performed when TSB had come down to the normal range. All the infants were followed up to 12 months. Results: During the study period, 77 of 83 infants were eligible, of which 71 had severe hyperbilirubinemia and six had hyperbilirubinemia in association with bilirubin-induced neurological dysfunction. Thirty-three infants were diagnosed with acute bilirubin encephalopathy (ABE), two of whom died of ABE, and 62 completed the follow-up, of which 12 infants had adverse outcomes. Sixtyfour infants underwent aEEG, 40 infants had cranial MRI, and 39 infants had ABR. Logistic regression and the receiver-operator characteristic curve analysis showed that the ability of severely abnormal aEEG to predict adverse neurological outcomes in severe hyperbilirubinemia was no better than abnormal ABR, with a sensitivity of 35.7% versus 83.3%, a specificity of 92.0% versus 74.1%, a positive predictive value of 55.6% versus 58.8%, and a negative predictive value of 83.6% versus 90.9%. Conclusions: Early aEEG could predict adverse neurodevelopmental outcomes in neonates with severe hyperbilirubinemia, although the sensitivity was lower than ABR. (C) 2019 The Authors. Published by Elsevier Inc.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

Amplitude-integrated electroencephalography

Auditory brainstem response

Bilirubin

acute bilirubin encephalopathy

neuropathy spectrum disorder

neonatal

hyperbilirubinemia

auditory neuropathy

late preterm

infants

management

system

toxicity

damage

Neurosciences & Neurology

Pediatrics

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