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Association between jaundice treatment and conventional electroencephalography (EEG) changes with spectral analysis in infants

J Neonatal Perinatal Med. 2026 Aug 14:19345798261475686. doi: 10.1177/19345798261475686. Online ahead of print.

ABSTRACT

ObjectiveNeonatal hyperbilirubinemia (NHB) is a common clinical condition that may lead to long-term neurodevelopmental impairment due to bilirubin-induced neurotoxicity. The development of reliable methods for neurological monitoring in affected newborns remains a major challenge in neonatal care. This study aimed to evaluate the association between treatment and EEG changes on cerebral activity in infants with hyperbilirubinemia using conventional EEG.Methods & MaterialsThis prospective before-and-after study was conducted on neonates aged over 35 weeks of gestation who were diagnosed with hyperbilirubinemia. Demographic and clinical data, including neonatal age, sex, birth weight, presence of ABO incompatibility, and treatment modalities, were collected. Maternal data, including parity, mode of delivery, and maternal and neonatal blood groups, were also recorded.Conventional EEG was performed for all neonates during the first eight hours of hospitalization and repeated after therapeutic interventions, including phototherapy and, when indicated, exchange transfusion.ResultsA total of 26 neonates with hyperbilirubinemia were included in this study. The mean total serum bilirubin level before treatment was 23.01 ± 2.99 mg/dL.A statistically significant change in the EEG spectral power was observed before and after treatment in the frontal regions Fp1, Fp2, and Fz, particularly within the delta and beta frequency bands.Furthermore, the findings demonstrated that delta activity was significantly dominant in the Fp1, Fp2, and Fz regions both before and after treatment. In contrast, no dominant frequency bands were observed in the C3, O1, T3, C4, T4, Cz, and O2 regions either before or after treatment.ConclusionHyperbilirubinemia in neonates may be associated with alterations in cortical electrical activity as assessed by conventional EEG. In our study, delta band activity was significantly predominant in the frontal regions (Fp1, Fp2, and Fz) both before and after treatment. Moreover, delta band activity remained the predominant frequency in the frontal regions (Fp1, Fp2, and Fz) before and after treatment, suggesting persistent frontal cortical involvement despite treatment.Further studies with larger samples are recommended to clarify whether these EEG changes reflect a transient bilirubin effect or age-related maturation patterns.

PMID:42596718 | DOI:10.1177/19345798261475686

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