Comparison of Cranial Ultrasound and Amplitude-Integrated Electroencephalography in Predicting Neurodevelopmental Outcomes in Neonates With Hypoxic-Ischemic Encephalopathy: A Systematic Review and Meta-Analysis.
Meirong Shu, Shilue Zhong, Bo Bao et al.
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In 30 seconds
This systematic review and meta-analysis assessed how amplitude-integrated electroencephalography (aEEG) and cranial ultrasound (cUS) predict neurodevelopmental outcomes in term and near-term neonates with hypoxic-ischaemic encephalopathy. Ten observational studies included 901 neonates. The pooled proportion with an adverse neurodevelopmental outcome was 0.44 (95% CI: 0.34-0.54; I 2 = 84.0%). For aEEG, the pooled diagnostic odds ratio for predicting an adverse outcome was 18.85 (95% CI: 7.31-48.65). Adverse outcome proportions were similar across aEEG, cUS, and conventional EEG-based patterns, with no significant between-group differences.
Key findings
- Across 10 studies and 901 neonates, the pooled proportion with adverse neurodevelopmental outcomes was 0.44 (95% CI: 0.34-0.54; I 2 = 84.0%).
- For aEEG, the pooled diagnostic odds ratio for adverse neurodevelopmental outcomes was 18.85 (95% CI: 7.31-48.65).
- Adverse outcome proportions were 0.43 for aEEG, 0.42 for cUS, and 0.50 for conventional EEG-based patterns, with no significant between-group differences.
- The pooled incidence of cerebral palsy was 0.02 (95% CI: 0.01-0.07), with low to moderate heterogeneity.
Why it matters
Neurodevelopmental impairment remains common among neonates with HIE, and early prognostic information can help frame follow-up and outcome assessment. These pooled findings suggest aEEG has prognostic value, while cUS may contribute complementary information. The substantial heterogeneity in adverse outcomes also underscores the difficulty of comparing prognostic performance across studies.
What to keep in mind
The review included observational studies, and adverse-outcome estimates showed substantial heterogeneity (I 2 = 84.0%).