振幅整合脑电图联合新生儿神经行为测定评估妊娠期糖尿病产妇新生儿脑发育

Analysis of the value of amplitude-integrated electroencephalogram combined with neonatal neurological and behavioral assessment for neonatal brain development of pregnant women with gestational diabetes mellitus

目的:探究振幅整合脑电图(aEEG)联合新生儿神经行为测定(NBNA)对妊娠期糖尿病(GDM)孕妇新生儿脑发育的评估价值。方法:选取2018年10月-2021年3月本院分娩的GDM产妇新生儿280例为观察组,健康产妇新生儿280例为对照组。两组新生儿均于出生后行aEEG监测和NBNA测定,分析aEEG及NBNA对新生儿脑发育的评估价值。结果:观察组aEEG异常(43例,15.4%)高于对照组(16例,5.7%)例,新生儿NBNA测定中一般反应、行为能力、被动肌张力、主动肌张力、原始反射的单项评分及NBNA总评分均低于对照组,新生儿NBNA测定异常率(17.5%)高于对照组(7.9%)(均P<0.05)。aEEG监测与NBNA测定的符合率观察组(95.7%)与对照组(96.4%)无差异(P>0.05)。aEEG、NBNA评估GDM产妇新生儿脑发育的曲线下面积(AUC)分别为0.808、0.824,灵敏度89.4%、90.2%,特异度70.7%、74.6%,二者联合评估的AUC为0.972,灵敏度98.3%、特异度为92.3%。结论:GDM孕妇新生儿脑发育异常发生率增加,aEEG和NBNA能够及早评估新生儿脑发育状况,联合评估价值最佳,当联合测定提示异常时应引起临床重视。

Objective:To explore the value of amplitude-integrated electroencephalogram electroencephalogram(aEEG)combined with neonatal neurological and behavioral assessment(NBNA)for neonatal brain development of pregnant women with gestational diabetes mellitus(GDM).Methods:A total of 280 neonates of the pregnant women with GDM who delivered in hospital were selected in research group,and 280 neonates of healthy pregnant women were selected in control group from October 2018 to March 2021.The aEEG monitor and NBNA were conducted on the neonates in both groups after birth,and the evaluative values of aEEG and NBNA for neonatal brain development were analyzed.Results:The aEEG abnormalities rate(43 cases,15.4%)of the neonates in the research group were significantly higher than that(16 cases,5.7%)of the neonates in the control group.The individual scores of general response,behavioral ability,passive muscle tone,active muscle tone,original reflex,and the total NBNA score of the neonates in research group were significantly lower than those of the neonates in the control group.The abnormal rate of NBNA measurement(17.5%)of the neonates in the research group was significantly higher than that of the neonates in the control group(all P<0.05).There was no significant difference in the coincidence rate of aEEG monitor and NBNA(95.7%vs.96.4%)between the two groups(P>0.05).The area under curve(AUC)of aEEG and NBNA for evaluating the neonatal brain development were 0.808 and 0.824,with the sensitivity of 89.4%and 90.2%,and the specificity of 70.7%and 74.6%,respectively.The AUC of the aEEG combined with NBNA for assessing the neonatal brain development was 0.972,with the sensitivity of 98.3%and the specificity of 92.3%.Conclusion:The abnormal incidence of neonatal brain development of the pregnant women GDM increases.The brain development of newborns can be evaluated by aEEG and NBNA as early as possible.The combined of aEEG and NBNA for evaluating neonatal brain development has the best value,and the abnormal result of which should be paid attention to in clinic.