Protein S100B and Amplitude-Integrated EEG as Early Predictive Methods for Brain Injury and Seizures in Preterm Neonates

Abstract

Background: Neonatal brain injury (NBI) is a serious adverse outcome in premature neonates. The most common form of neonatal brain injury (NBI) are intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL). Improved survival of preterm infants leads to short- and long-term hazards of neurological, cognitive, respiratory, digestive, renal, cardiovascular, metabolic, immune, and psychosocial disturbances. We sought to determine the levels and prognostic value of serum S100B and the role of aEEG during the first three days of life in premature neonates (< 37 weeks) that later developed NBI in the form of intraventricular hemorrhage (IVH) or neonatal seizures to rule out the sensitivity and specificity of them in early detection of brain lesions in preterm neonates.
 Aim of the Study: To evaluate the role of Protein S100B as an early predictor for neonatal brain injury in preterm neonates and the predictive and prognostic value of amplitude-integrated electroencephalography for neonatal brain injury susceptibility and severity.
 Subject and Methods: This study was carried out on 50 preterm neonate (less than 37 weeks GA) who were divided according to presence or absence of brain injury into case and control groups. They were admitted in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital during the period from March 2021 to March 2022.serum S100B at (Day 1 and Day 3), serial trans-cranial sonar and aEEG were done for all patients.
 Results: Neonates with NBI, had significantly higher S100B concentration during the first three days of life, its level was higher in the third day than the first day, the cut-off value >810.4 ng/ml serum S100B performed a sensitivity of 72.7%and a specificity of 71.4% to predict adverse neonatal outcome. 60% neonates had normal aEEG and 40% had abnormal aEEG.72.7% of neonates with NBI had abnormal aEEG interpretation. There was a significant relationship between the electrografic seizures on aEEG and occurrence of clinical seizures as 96.7% of neonates who had abnormal aEEG suffered of clinical convulsion.
 Conclusion: Protein S100B has a good predictive value regarding NBI in premature neonates and aEEG has a great role in monitoring neonatal brain function and early detection of neonatal seizures.