Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants

Abstract

BACKGROUND: Delayed brain function development in small-gestational-age (SGA) infants has been reported. We aimed to quantify rates of immature neonatal EEG patterns and their association with neurodevelopment in SGA full-term neonates. METHODS: Using a cohort design, 50 SGA (birthweight <10th percentile) and 44 appropriate-gestational-age (AGA) term neonates underwent continuous video-EEG recordings lasting >3 h. Seventy-three of them were assessed at 2-years-old using Bayley-III-Scales. For EEG analysis, several segments of discontinuous/alternating EEG tracings were selected. Main outcomes measured: (1) Visual analysis (patterns of EEG maturity); (2) Power spectrum in δ, θ, α and β frequency bands; and (3) scores in motor, cognitive and language development. RESULTS: (1) SGA infants, compared to AGA, showed: (a) higher percentages of discontinuous EEG, both asynchrony and interhemispheric asymmetry, and bursts with delta-brushes, longer interburst-interval duration and more transients/hour; (b) lower relative power spectrum in δ and higher in α; and (c) lower scores on motor, language and cognitive neurodevelopment. (2) Asymmetry >5%, interburst-interval >5 s, discontinuity >11%, and bursts with delta-brushes >11% were associated with lower scores on Bayley-III. CONCLUSIONS: In this prospective study, SGA full-term neonates showed high rates of immature EEG patterns. Low-birthweight and immaturity EEG were both correlated with low development scores.

Early Diagnosis of Brain Injury in Premature Infants Based on Amplitude-Integrated EEG Scoring System

“…There are two main types of brain injury in premature infants, namely, intracranial hemorrhage and periventricular white matter softening. Severe brain damage in premature infants can lead to death or moderate-to-severe neurodevelopmental disorders, including cerebral palsy, mental retardation, and vision and hearing impairment, and seriously affect the quality of life of preterm infants [ 4 , 5 ]. Therefore, the early evaluation and prevention of brain injury and its adverse neurological prognosis in preterm infants have become the focus of medical research in preterm infants.…”

Evidence of changes in the oral language in children born full-term and small for gestational age: a systematic review

“…In the three studies in this review that used the scale, 33 , 34 , 37 a lower performance was found in the assessed domains in the SGA group when compared to the AGA group, as it was not observed in the study by O’Neill et al 32 …”

“…Regarding the SGA classification, a Japanese study considered birth weight below the tenth percentile for gestational age (GA) and birth length below -2.0 standard deviation (SD) for GA, or birth weight below -2.0 SD for GA and length below the tenth percentile for GA. 31 In the other studies 29 , 30 , 32 – 37 only birth weight below the tenth percentile for GA was considered according to local standards, based on the uterine growth curve. 3 , 5 Some authors 30 reported that they disregarded height due to inaccuracies in the measurements at birth, following the evidence.…”

“…In the reviewed studies, there was a diversity of objectives, with few being directed to the evaluation of some aspect of language. 29 , 35 In the other selected studies, 30 – 34 , 36 , 37 this ability was described as being part of the tests that assessed cognitive skills and neurobehavioral aspects of development.…”

“…It was used the average age group of two years to perform the assessment. 32 – 34 , 37 In other studies, 30 , 31 aspects of language were mentioned, but they used questionnaires directed at parents who investigated issues related to neurodevelopment and behavior as instruments.…”