Comparison of Cranial Ultrasound and Amplitude‐Integrated Electroencephalography in Predicting Neurodevelopmental Outcomes in Neonates With Hypoxic–Ischemic Encephalopathy: A Systematic Review and Meta‐Analysis
- 1Department of Ultrasound Haikou People's Hospital Haikou China
- 2Department of Functional(Electroencephalography Room) Haikou People's Hospital Haikou China
Abstract
Background: Hypoxic–ischemic encephalopathy (HIE) remains a leading cause of neonatal mortality and long‐term neurodevelopmental impairment.
Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to the latest update for observational studies evaluating the prognostic value of aEEG and/or cUS in term and near‐term neonates with HIE. The primary outcome was adverse neurodevelopmental outcome, and the secondary outcome was cerebral palsy (CP). Random‐effects models were applied to estimate pooled proportions and diagnostic performance metrics. Heterogeneity was assessed using the I 2 statistic, with meta‐regression and sensitivity analyses conducted to explore potential sources of heterogeneity and result robustness.
Results: Ten studies involving 901 neonates with HIE were included. The pooled proportion of adverse neurodevelopmental outcomes (NDO) was 0.44 (95% CI: 0.34–0.54; I 2 = 84.0%). Subgroup analyses demonstrated similar adverse outcome proportions for aEEG (0.43), cUS (0.42), and conventional EEG‐based patterns (0.50), with no significant between‐group differences. For aEEG, the pooled diagnostic odds ratio for predicting adverse NDO was 18.85 (95% CI: 7.31–48.65). The pooled incidence of CP was 0.02 (95% CI: 0.01–0.07), with low to moderate heterogeneity. Meta‐regression did not identify publication year or assessment timing as significant contributors to heterogeneity, and sensitivity analyses confirmed result stability.
Conclusions: Adverse NDO remain frequent in neonates with HIE. aEEG demonstrates strong prognostic value for early prediction of unfavorable NDO, while cUS provides complementary but less definitive prognostic information. Standardized assessment protocols and outcome definitions are required to improve neuroprognostication in neonatal HIE.
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BibTeX
@article{shu2026comparison,
title = {{Comparison of Cranial Ultrasound and Amplitude‐Integrated Electroencephalography in Predicting Neurodevelopmental Outcomes in Neonates With Hypoxic–Ischemic Encephalopathy: A Systematic Review and Meta‐Analysis}},
author = {Meirong Shu and Shilue Zhong and Bo Bao and Dandan Xu and Yingfeng Jiang and Dongxue Lin and Jingzhi Su},
journal = {Journal of Clinical Ultrasound},
year = {2026},
month = jul,
doi = {10.1002/jcu.70340},
url = {https://doi.org/10.1002/jcu.70340},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparison of Cranial Ultrasound and Amplitude‐Integrated Electroencephalography in Predicting Neurodevelopmental Outcomes in Neonates With Hypoxic–Ischemic Encephalopathy: A Systematic Review and Meta‐Analysis
AU - Meirong Shu
AU - Shilue Zhong
AU - Bo Bao
AU - Dandan Xu
AU - Yingfeng Jiang
AU - Dongxue Lin
AU - Jingzhi Su
PY - 2026
DA - 2026/07/17
JO - Journal of Clinical Ultrasound
DO - 10.1002/jcu.70340
UR - https://doi.org/10.1002/jcu.70340
AB - Background: Hypoxic–ischemic encephalopathy (HIE) remains a leading cause of neonatal mortality and long‐term neurodevelopmental impairment. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to the latest update for observational studies evaluating the prognostic value of aEEG and/or cUS in term and near‐term neonates with HIE. The primary outcome was adverse neurodevelopmental outcome, and the secondary outcome was cerebral palsy (CP). Random‐effects models were applied to estimate pooled proportions and diagnostic performance metrics. Heterogeneity was assessed using the I 2 statistic, with meta‐regression and sensitivity analyses conducted to explore potential sources of heterogeneity and result robustness. Results: Ten studies involving 901 neonates with HIE were included. The pooled proportion of adverse neurodevelopmental outcomes (NDO) was 0.44 (95% CI: 0.34–0.54; I 2 = 84.0%). Subgroup analyses demonstrated similar adverse outcome proportions for aEEG (0.43), cUS (0.42), and conventional EEG‐based patterns (0.50), with no significant between‐group differences. For aEEG, the pooled diagnostic odds ratio for predicting adverse NDO was 18.85 (95% CI: 7.31–48.65). The pooled incidence of CP was 0.02 (95% CI: 0.01–0.07), with low to moderate heterogeneity. Meta‐regression did not identify publication year or assessment timing as significant contributors to heterogeneity, and sensitivity analyses confirmed result stability. Conclusions: Adverse NDO remain frequent in neonates with HIE. aEEG demonstrates strong prognostic value for early prediction of unfavorable NDO, while cUS provides complementary but less definitive prognostic information. Standardized assessment protocols and outcome definitions are required to improve neuroprognostication in neonatal HIE.
SN - 0091-2751
SN - 1097-0096
ER -