{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:15:56Z","timestamp":1790363756778,"version":"4.1.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,7,1]]},"abstract":"<jats:p>BACKGROUND. After perinatal asphyxia, predicting which infants will develop significant hypoxic-ischemic encephalopathy and neonatal seizures remains a difficult task. High-risk markers (Apgar score, acidosis, nucleated red blood cells, and resuscitation) have been used to predict neonatal seizures with varying success. The \u201c3 strikes\u201d of Apgar score of &amp;lt;5 at 5 minutes, pH &amp;lt;7.00, and need for intubation have been cited as having a positive predictive value of 80%. We examined whether the predictive values of these markers would be increased if early continuous electroencephalographic monitoring allowed us to accurately identify all neonatal seizures and to grade the encephalopathy.<\/jats:p><jats:p>METHOD. We recruited term infants with perinatal asphyxia. Continuous video electroencephalography was commenced soon after birth and continued for 24 to 72 hours. The abilities of high-risk markers to predict electroencephalographic seizurs, background electroencephalographic activity, and Sarnat grade were examined.<\/jats:p><jats:p>RESULTS. Forty-nine infants were suitable for analysis. Electrographic seizures occurred in 11 of the 49 infants. Encephalopathy was scored by using Sarnat grade (6, severe; 18, moderate; 25, mild) and electroencephalographic findings (4 inactive, 4 major abnormalities, 16 moderate abnormalities, and 25 normal\/mildly abnormal). Apgar score of &amp;lt;5 at 5 minutes, pH &amp;lt;7.0, and the need for intubation had positive predictive values for neonatal seizures of 18%, 16%, and 21%, respectively. Combining these markers gave a positive predictive value of 25% and a negative predictive value of 77%. Substituting base deficit or lactate for pH in the 3-strikes model did not improve its predictive value. Apgar score of &amp;lt;5 at 5 minutes, nucleated red blood cells, and a base deficit less than \u221215 mEq\/L showed some association with Sarnat grade. Only 5-minute Apgar score was significantly associated with both Sarnat grade and electroencephalographic grade.<\/jats:p><jats:p>CONCLUSION. After perinatal asphyxia, neither the condition at birth nor the degree of metabolic acidosis reliably predict neonatal seizures.<\/jats:p>","DOI":"10.1542\/peds.2005-1524","type":"journal-article","created":{"date-parts":[[2006,7,6]],"date-time":"2006-07-06T16:42:48Z","timestamp":1152204168000},"page":"41-46","source":"Crossref","is-referenced-by-count":72,"title":["Prediction of Seizures in Asphyxiated Neonates: Correlation With Continuous Video-Electroencephalographic Monitoring"],"prefix":"10.1542","volume":"118","author":[{"given":"Deidre M.","family":"Murray","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, University College Cork, Unified Maternity Services, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Anthony","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University College Cork, Unified Maternity Services, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine B.","family":"Boylan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University College Cork, Unified Maternity Services, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony P.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University College, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,7,1]]},"reference":[{"key":"2021120823083302400_R1","unstructured":"Volpe JJ. 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