Abstract:
OBJECTIVE: The aim of the study is to model amplitude-integrated electroencephalography (aEEG) utility to diagnose seizures in common clinical scenarios. STUDY DESIGN: Using reported neonatal seizure prevalence and aEEG sensitivities and specificities, likelihood ratios (LRs) and post-test probabilities were calculated to quantify aEEG utility to diagnose seizures in three typical clinical scenarios. RESULTS: Prevalence data supported pretest probabilities for neonatal seizures of 0.4 in neonatal hypoxic ischemic encephalopathy (HIE), 0.27 in bacterial meningitis, and 0.05 in extreme prematurity. Reported sensitivity of 85% and specificity of 90% for seizures with expert aEEG interpretation yielded a positive likelihood ratio (LR+) of 8.7 and a negative likelihood ratio (LR-) of 0.17. Reported sensitivity of 65% and specificity of 70% with intermediate interpretation yielded LR+ 2.17 and LR- 0.5. Reported sensitivity of 40% and sensitivity of 50% with inexperienced interpretation gave LR+ 0.8 and LR- 1.2. These translate the ability to move pretest to post-test probability highly dependent on user expertise. For HIE, a pretest probability of seizure of 0.4 moves to a post-test probability of 0.85 when aEEG is positive for seizures by expert interpretation, and down to 0.1 when aEEG is negative. In contrast, no useful information was gained between pretest and post-test probability by aEEG interpreted as negative or positive for seizure at the inexperienced user level. Similarly, in the models of meningitis or extreme prematurity, incremental information gained from aEEG ranged widely based on interpreter experience. CONCLUSION: aEEG is most useful to screen for neonatal seizures when used in conditions with high seizure prevalence, and when interpretation has a sensitivity and specificity as reported for expert users. In contrast, aEEG can become negligible in providing meaningful clinical information when applied in conditions having lower seizure prevalence or when interpretation has low accuracy. Appropriate patient selection and high quality interpretation are essential for aEEG utility in neonatal seizure detection. KEY POINTS:· aEEG utility for neonatal seizure screening relies on patient selection and quality interpretation.. · Utility of aEEG is highest with high seizure prevalence and expert interpretation.. · Utility of aEEG can be negligible with lower seizure prevalence or low accuracy interpretation..
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Sandoval Karamian AG,Wusthoff CJdoi
10.1055/s-0040-1721711subject
Has Abstractpub_date
2020-12-15 00:00:00eissn
0735-1631issn
1098-8785pub_type
杂志文章abstract::The use of transabdominal vibroacoustic stimulation has been shown to improve the efficiency of antepartum fetal surveillance. The ability of the fetus to habituate to such a stimulus has also been suggested as a means of assessing the function of the central nervous system. The purpose of this blinded prospective inv...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999420
更新日期:1991-11-01 00:00:00
abstract::Two cases of fetal myocardial calcification confirmed postnatally are reported. In contrast to other reports, both infants survived with resolution of calcification by 6 and 12 months. Diagnostic investigations failed to confirm the presence of congenital infection. Both pregnancies were complicated by early cocaine u...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040740
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1-binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins w...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1677472
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Postnatal assessment of disease severity is critical for analysis of mortality rates and development of future interventions in congenital diaphragmatic hernia (CDH). OBJECTIVE:The objective of this study was to stratify the risk of mortality based on arterial Paco 2. METHODS:Retrospective analysis of infa...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1368088
更新日期:2014-11-01 00:00:00
abstract::Disulfiram has been used effectively to deter alcohol consumption in patients with a history of alcohol abuse. Its use in reproductive age women has become increasingly common in recent years, intensifying the risk of fetal exposure. Nonspecific but significant abnormalities have been described in the infants of women...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994688
更新日期:1993-01-01 00:00:00
abstract::Gestational diabetes mellitus (GDM) has increased dramatically in the past 20 years together with the obesity epidemic. Mirroring the increase in incidence of GDM is increasing use of endocrine disrupting chemicals (EDCs). EDCs are structurally similar to endogenous hormones and interfere with synthesis, secretion, ac...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1586500
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE: This work aimed to study perinatal, maternal, and neonatal characteristics of birth tourism (BT) mother-baby dyads and the rate of neonatal intensive care unit (NICU) admissions of BT infants. STUDY DESIGN: Retrospective study at a regional perinatal center comparing BT mother-baby dyads to all dyads. BT in...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1719117
更新日期:2020-11-09 00:00:00
abstract::We sought (1) to identify risk factors for meconium aspiration syndrome (MAS) among infants born to women whose labors were complicated by thick-consistency meconium-stained amniotic fluid (MSAF), and (2) to determine whether risk factors and infant prognosis differ according to the time of onset of respiratory distre...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0029-1241740
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE: This article determines the tolerance of neonatal intensive care unit (NICU)-based administration of RV5 in premature infants. This article also aims to compare the rate of clinically significant adverse events after RV5 immunization to the standard 2-month shot series and to historical controls who were not...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1698455
更新日期:2019-11-18 00:00:00
abstract::A patient with a homozygous marital partner had three progressively less seriously involved RH-positive babies after a fetal demise due to erythroblastosis. Only the first of the three required fetal transfusions. All were Rh genotypically identical. The case is presented for interest and to illustrate an exception to...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999655
更新日期:1988-01-01 00:00:00
abstract::Carbamoyl phosphate synthetase deficiency is a type of an inborn error of metabolism with a poor prognosis. Carbamoyl phosphate synthetase is a liver-specific enzyme, and its deficiency can only be diagnosed by enzyme assay using liver biopsy specimens. A pregnant woman at risk for carbamoyl phosphate synthetase defic...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-994579
更新日期:1994-03-01 00:00:00
abstract:AIM:The main purpose of this article is to assess trends in cytomegalovirus (CMV) infection reported among infants in California neonatal intensive care units (NICUs) during 2005 to 2016. STUDY DESIGN:The California Perinatal Quality Care Collaborative collects data on all very low birth weight (VLBW, birth weight ≤ 1...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1683958
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the impact of multiple pregnancies, maternal obesity, and preeclampsia on the effect of antenatal steroids on neonatal respiratory distress syndrome (RDS). STUDY DESIGN:The retrospective cohort study was performed in a level III maternity ward. Population was composed of ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1548537
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to investigate whether maternal bronchial asthma increases the risk for long-term respiratory morbidity of the offspring. STUDY DESIGN:A population-based cohort study compared the incidence of long-term pediatric hospitalizations due to respiratory disease of the offspring of ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1639507
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. STUDY DESIGN:This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676484
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:This article identifies the prevalence and associated factors of hypophosphatemia (HP) in very low birth weight (VLBW) infants in the first week of life. STUDY DESIGN:Prospective exploratory cohort study of 106 consecutive VLBW infants admitted to neonatal intensive care at Foothills Hospital, Calgary, Canad...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1677713
更新日期:2019-11-01 00:00:00
abstract:UNLABELLED:We evaluated the effectiveness of oral misoprostol for outpatient cervical ripening and labor induction in prolonged pregnancies. We performed a randomized, double-blind, placebo-controlled study of women at 40 to 42 weeks' gestation with well-dated pregnancies, singleton gestations, Bishop scores less than ...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0029-1220790
更新日期:2009-10-01 00:00:00
abstract::A hospital-based case-controlled study was undertaken to determine maternal and neonatal characteristics associated with fractured clavicle. A total of 11,604 consecutive vaginal deliveries of liveborn infants in vertex presentation at the Mount Sinai Hospital from 1988 to 1990 were reviewed. Maternal and neonatal cha...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994546
更新日期:1994-09-01 00:00:00
abstract::We sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223287
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE: This study aimed to assess risk for fetal acidemia, low Apgar scores, and hypoxic ischemic encephalopathy based on decision-to-incision time interval in the setting of emergency cesarean delivery. STUDY DESIGN: This unplanned secondary analysis of the Maternal-Fetal Medicine Units prospective observational ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1717068
更新日期:2020-09-21 00:00:00
abstract::The primary objective of this study was to determine whether having the sickle cell trait is independently associated with preeclampsia. We performed a retrospective cohort study of 1998 pregnant patients who either did or did not have the sickle cell trait. All patients were screened for the sickle trait using the "S...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-37953
更新日期:2003-01-01 00:00:00
abstract::Objective To compare maternal birth complications early versus late in the academic year and to evaluate the impact of resident work hour limitation on the "July effect." Study Design We conducted a retrospective, population-based cohort study of 628,414 singleton births in Washington State from 1987 to 2012 measuring...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0037-1598244
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE: The aim of this study is to determine patterns of neurally adjusted ventilatory assist (NAVA) use in ventilator-dependent preterm infants with evolving or established severe bronchopulmonary dysplasia (sBPD) among centers of the BPD Collaborative, including indications for its initiation, discontinuation, an...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1708559
更新日期:2020-03-24 00:00:00
abstract:OBJECTIVE: Sepsis is a major cause of neonatal mortality. The gold standard for diagnosis is blood culture which suffers from low sensitivity and huge turn-around time. Flow cytometry has been extensively applied to malignant disorders and is an upcoming tool for diagnosis of nonmalignant disorders due to its rapidity ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1718370
更新日期:2020-09-29 00:00:00
abstract::Conventional interval dosing (CID) and extended interval dosing (EID) of gentamicin were compared in preterm infants. Gentamicin peak and trough levels, serum creatinine, urine output, and hearing screens were obtained in 40 preterm infants. Results suggest that EID is safe, provides gentamicin levels in desirable ran...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2004-820515
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of pretreatment with obestatin (OB), an endogenous hormone also found in mother's milk, in experimental necrotizing enterocolitis (NEC). STUDY DESIGN:Pups were randomized into four groups: control, OB-control, NEC, and OB-NEC. NEC was induced by asphyxia and hypothermia in the NEC a...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676491
更新日期:2019-09-01 00:00:00
abstract::We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almos...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1110088
更新日期:2009-05-01 00:00:00
abstract::We have examined the safety and efficacy of an early postpartum discharge program in 289 patients who were identified prior to delivery and counseled and educated for discharge 12 to 36 hours after delivery. A total of 55% of the study patients were able to be discharged early. There were 4.3% significant maternal pro...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994768
更新日期:1993-09-01 00:00:00
abstract::We compared lymphocyte subsets and cytokine responses to bacteria among term, preterm infants, and adults. Lymphocyte subset percentages in cord blood (22 preterm, 27 term neonates) and peripheral blood from 21 adults and cytokine/chemokine interleukin (IL)-6, IL-8, IL-10, IL-12, interferon gamma (IFN gamma) responses...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1220788
更新日期:2009-10-01 00:00:00
abstract::Introduction First-trimester ultrasound (US) for anatomy assessment may improve anomaly detection, but it may also increase overall US utilization. We sought to assess the utility of first-trimester US for evaluation of fetal anatomy. Materials and Methods A decision analytic model was created to compare first- plus s...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1579652
更新日期:2016-08-01 00:00:00