{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:01:26Z","timestamp":1792645286511,"version":"4.5.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,2,1]]},"abstract":"<jats:p>Objectives. The objectives of this study were to determine, first, whether an early neurologic examination could predict a persistent abnormal neonatal neurologic state comparable to the amplitude-integrated electroencephalography (a-EEG) and, second, whether a combination of the 2 methods would further enhance early identification of high-risk infants.<\/jats:p><jats:p>Methods. Fifty term infants were enrolled prospectively when they had evidence of intrapartum distress, Apgar score \u22645 at 5 minutes, or cord arterial pH \u22647.00 and were admitted to intensive care. Each enrolled infant underwent an early neurologic examination using a modified Sarnat staging system (stages 2 and 3 were regarded as abnormal) and a blinded simultaneous a-EEG measurement. Predictive values were calculated for a short-term abnormal outcome defined as persistent moderate to severe encephalopathy beyond 5 days.<\/jats:p><jats:p>Results. An abnormal short-term outcome was present in 14 (28%) of 50 infants. The neurologic examination was performed at 5 \u00b1 3 hours after delivery. A short-term abnormal outcome occurred in 9 (53%) of 17 infants with initial stage 2 and in both infants with initial stage 3 encephalopathy. In addition, 13 infants manifested features of both stage 1s and 2 and post hoc were classified (S1\u20132). Three of the latter infants (23%) developed an abnormal short-term outcome. The a-EEG was abnormal in 15 (30%) infants, 11 (73%) of whom developed an abnormal outcome. An abnormal a-EEG was more specific (89% vs 78%), had a greater positive predictive value (73% vs 58%), and had similar sensitivity (79% vs 78%) and negative predictive value (90% vs 91%) when compared with an abnormal early neurologic examination. A combination of abnormalities had the highest specificity (94%) and positive predictive value (85%).<\/jats:p><jats:p>Conclusion. The combination of the a-EEG and the neurologic examination shortly after birth enhances the ability to identify high-risk infants and limits the number of infants who would be falsely identified compared with either evaluation alone.<\/jats:p>","DOI":"10.1542\/peds.111.2.351","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"351-357","source":"Crossref","is-referenced-by-count":210,"title":["Amplitude-Integrated Electroencephalography Coupled With an Early Neurologic Examination Enhances Prediction of Term Infants at Risk for Persistent Encephalopathy"],"prefix":"10.1542","volume":"111","author":[{"given":"Lina F.","family":"Shalak","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sithembiso C.","family":"Velaphi","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Perlman","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,2,1]]},"reference":[{"key":"2021121010102136000_R1","unstructured":"Laptook AR, Corbett RJT. 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