Electroencephalography in Preterm Infants for Predicting Neurodevelopmental Outcomes: A Systematic Review and Diagnostic Test Accuracy Meta-Analysis

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-02-27 DOI:10.1016/j.pediatrneurol.2025.02.010

Vijay Kumar Krishnegowda DrNB , Prathik Bandiya DM , Tapas Bandyopadhyay DM , Haribalakrishna Balasubramanian DM , Daniele Trevisanuto MD , Viraraghavan Vadakkencherry Ramaswamy DM

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引用次数: 0

Abstract

Background

Electroencephalography (EEG) and amplitude-integrated EEG (aEEG) have been utilized to predict neurodevelopmental impairment (NDI) in preterm infants.

Methods

MEDLINE, SCOPUS, Embase, Web of Science, and Cochrane Library were searched from inception until November 1, 2023. Observational studies evaluating EEG and aEEG and neurodevelopment assessment performed at least after six months corrected age (CA) were included. A diagnostic test accuracy (DTA) meta-analysis using a Bayesian random-effects bivariate model was performed. QUADAS-2 was used to assess the risk of bias, and GRADE approach was used to ascertain the certainty of evidence.

Results

Thirty-eight studies (n = 4667) were included in the systematic review of which 26 studies (n = 3363) were synthesized in a DTA meta-analysis. EEG and aEEG had a sensitivity of 63.9% (95% credible intervals [CrI]: 52.1%, 76.3%) and specificity of 87.6% (80.9%, 94.1%) for the outcome of any NDI (<1 S.D. from the mean value for the CA). For the outcome of severe NDI (<2 S.D.s from the mean value for the CA) (10 studies, n = 1075), the sensitivity was 59.7% (42.3%, 75.9%) and specificity was 85.2% (72.7%, 92.4%). Evidence certainty was very low to low. Subgroup analysis of studies that had utilized Bayley Scales of Infant and Toddler Development between 18 and 30 months CA (12 studies, n = 1202) for neurodevelopmental assessment revealed a sensitivity of 59% (42.3%, 74.7%) and specificity of 83.7% (75.8%, 90.1%) for any NDI.

Conclusion

EEG and aEEG possibly have suboptimal sensitivity and an acceptable-to-high specificity in predicting any NDI and severe NDI in preterm infants.

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预测早产儿神经发育结果的脑电图：系统回顾和诊断测试准确性meta分析

背景脑电图（EEG）和波幅积分脑电图（aEEG）已被用于预测早产儿的神经发育障碍（NDI）。方法检索medline、SCOPUS、Embase、Web of Science和Cochrane Library，检索时间为建库至2023年11月1日。观察性研究评估EEG和aEEG以及至少在6个月矫正年龄（CA）后进行的神经发育评估。采用贝叶斯随机效应双变量模型进行诊断测试准确性（DTA）荟萃分析。采用QUADAS-2评估偏倚风险，采用GRADE方法确定证据的确定性。结果38项研究（n = 4667）被纳入系统评价，其中26项研究（n = 3363）被纳入DTA荟萃分析。EEG和aEEG对任何NDI结果的敏感性为63.9%(95%可信区间[CrI]: 52.1%, 76.3%)，特异性为87.6%(80.9%,94.1%)（与CA的平均值相差1 sd）。对于严重NDI的结果（与CA的平均值相比有2个sd）（10项研究，n = 1075），敏感性为59.7%(42.3%,75.9%)，特异性为85.2%（72.7%,92.4%）。证据确定性非常低。使用Bayley婴幼儿发育量表进行神经发育评估的研究（12项研究，n = 1202）的亚组分析显示，对任何NDI的敏感性为59%(42.3%,74.7%)，特异性为83.7%（75.8%,90.1%）。结论脑电图和aEEG在预测早产儿任何NDI和重度NDI方面可能具有较低的敏感性和可接受到高的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.