| Title: |
Automated EEG Background Analysis and 2-Year Outcomes in Neonatal Hypoxic-Ischemic Encephalopathy |
| Authors: |
Cornet, Marie‐Coralie; Numis, Adam L.; Wusthoff, Courtney J.; Bernardo, Danilo; Mietzsch, Ulrike; Cameron, Thomas M; Natarajan, Niranjana; Ahmad, Kaashif A.; Scheffler, Aaron; Juul, Sandra E.; Montazeri Moghadam, Saeed; Wu, Yvonne W.; Glass, Hannah C. |
| Contributors: |
Department of Neurosciences; HUS Children and Adolescents; Children's Hospital; Department of Physiology; Kliinisen neurofysiologian yksikkö |
| Publisher Information: |
American Medical Association |
| Publication Year: |
2026 |
| Collection: |
Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| Subject Terms: |
Electroencephalography; Infants; Interrater agreement; System; Gynaecology and paediatrics |
| Description: |
Importance Hypoxic-ischemic encephalopathy (HIE) remains an important contributor to neonatal mortality and morbidity despite therapeutic hypothermia. Accurate early prognostication of outcomes is essential for clinical management and risk stratification in future trials. Objective To evaluate the feasibility and estimative ability of automated electroencephalographic (EEG) background analysis in projecting neurodevelopmental outcomes in neonates with HIE using the Brain State of the Newborn (BSN) score. Design, Setting, and Participants This cohort study was a secondary analysis of the High-Dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) trial, which enrolled infants born between January 25, 2017, and October 9, 2019, and were followed up at age 2 years (between age 22 and 36 months). Nine academic centers across the US provided raw EEG data starting within the first 24 hours of life. The data were analyzed between August 15, 2024, and August 25, 2025. Main Outcomes and Measures The primary outcome was death or severe neurodevelopmental impairment (NDI) at age 2 years. The BSN scores were computed using a cloud service and correlated with expert reader interpretations. Generalized linear mixed models were used to assess the estimative capabilities (quantified via cross-validated area under the receiver operating characteristic curve [AUROC]) of clinical variables and BSN score for severe NDI or death. Results Among 500 infants enrolled in the HEAL trial, 203 were included in the current analysis (median [IQR] gestational age, 39.3 [38.0-40.3] weeks; 121 male [59.6%]). Of these infants, 21 (10.3%) experienced severe NDI, and 28 (13.8%) died. The BSN scores correlated with expert reader EEG background classifications (Pearson correlation coefficient for median BSN, 0.69; 95% CI, 0.64-0.73). Adding median overall BSN score (AUROC, 0.90; 95% CI, 0.84-0.97) or median BSN score at all time points (AUROC, 0.93; 95% CI, 0.88-0.98) significantly improved the prognosis of severe NDI or death compared with ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
This study was supported by grants 1U01NS092764, U01NS092553, and R01NS104322 from the National Institute of Neurological Diseases and Stroke and K23HD109684 from the National Institute of Child Health and Human Development and by the Sigrid Juselius Foundation.; https://hdl.handle.net/10138/625556; 105024984118; 001643376700004 |
| Availability: |
https://hdl.handle.net/10138/625556 |
| Rights: |
cc_by ; info:eu-repo/semantics/openAccess ; openAccess |
| Accession Number: |
edsbas.63707E79 |
| Database: |
BASE |