Effectiveness of amplitude-integrated electroencephalography combined with neuron-specific enolase level in predicting neonatal brain injury and prognosis.

Objective: To investigate the value of amplitude-integrated electroencephalography (aEEG) combined with neuron-specific enolase (NSE) in the diagnosis and prognostic assessment of neonatal brain injury.

Methods: Clinical data from 94 neonates with brain injury and 90 neonates without, admitted to Baoji Maternity and Child Healthcare Hospital between September 2022 and February 2024, were retrospectively analyzed. The relationship between aEEG score, NSE level, and Neurobehavioral Neurological Assay (NBNA) score was analyzed by Pearson's correlation analysis. Independent factors affecting the prognosis of the neonates were identified by unifactorial and multifactorial analyses, and the predictive value was assessed using ROC curves.

Results: The aEEG score was significantly lower while the NSE level was considerably higher in newborns with brain injury compared to those without (both P<0.001). aEEG score was positively correlated with the NBNA score (r=0.718, P<0.001), NSE level was negatively correlated with NBNA score (r=-0.785, P<0.001), and aEEG score was negatively correlated with NSE level (r=-0.749, P<0.001). The aEEG score and NSE level demonstrated good predictive value for neonatal brain injury, with AUC values of 0.903 and 0.897, respectively. The AUC of combined assessment was 0.917. Multifactorial analysis showed that intrauterine distress (OR: 3.385, 95% CI: 1.033-11.903, P=0.048) and higher NSE level (OR: 1.516, 95% CI: 1.117-2.136, P=0.011) were independent risk factors for poor prognosis of neonates with brain injury, while higher aEEG scores (OR: 0.587, 95% CI: 0.370-0.884, P=0.015) was an independent protective factor. Intrauterine distress, aEEG score, and NSE predicted poor prognostic outcomes with AUCs of 0.639, 0.809, and 0.827, and the combined diagnosis had an AUC of 0.871.

Conclusion: aEEG combined with NSE level can effectively predict neonatal brain injury and prognosis, providing a valuable reference for early diagnosis and intervention.