Neonatal EEG and neurodevelopmental outcome in preterm infants born before 32 weeks

Abstract

Of the 1744 infants assessed at 2 years, 422 had a non-optimal outcome. A total of 4804 EEGs were performed, and 1345 infants had at least one EEG. EEG abnormalities were predictive of non-optimal outcomes after controlling for confounding factors such as severe intracranial lesions detected by brain imaging. Transient moderate and severe abnormalities were independent predictors of non-optimal outcomes with an OR and 95% CI of 1.49 (1.08 to 2.04) and 2.38 (1.49 to 3.81), respectively. In the validation group, the predictive risk stratification tree identified severe abnormalities as a factor contributing to the prognosis of two subgroups: infants with severe cranial lesions and infants with a normal examination at discharge and without severe cranial lesions.

EEG - A Valuable Biomarker of Brain Injury in Preterm Infants

“…Pioneering studies have shown that the EEG provides valuable prognostic information in preterm infants [32,[43][44][45][46][47][48][49][50] , and this has been confirmed by other more recent studies [25,[51][52][53][54][55][56][57] .…”

Neurodevelopmental outcome in very preterm and very‐low‐birthweight infants born over the past decade: a meta‐analytic review

“…Some developmental scales only provide an overall general developmental quotient, such as the Griffith's developmental scales, which was used in three studies, and the Brunet–Lézine test used in the study of Perivier et al …”

“…24,25,29,[38][39][40] Infants included in the follow-up had significantly (p<0.05) lower mean birthweight 25,29,38 and gestational age, 25,38,40 and were more severely ill (days on mechanical ventilation, 25,29 sepsis, 25,29,38 infection, 24,40 bronchopulmonary dysplasia, 25,39 chorioamnionitis, 24 chronic lung disease, 38 and inferior neuromotor examination at discharge). 40 Two studies observed differences in maternal characteristics. 24,39 Delmas et al 24 found non-significant differences between both groups with respect to higher maternal education (60% in the follow-up group and 35.3% for the lost-to-follow-up group, p=0.074); and in the study of Patra et al, 39 mothers were slightly younger in the lost-to-follow-up group (not significant).…”

Brain structure assessed using diffusion MRI and function assessed using quantitative EEG in very preterm infants and the ability to predict neurodevelopmental outcomes

“…Electroencephalography (EEG) is an established method that is non-invasive and relatively inexpensive to assess brain function in both healthy and abnormal states in newborn infants (Tharp, Scher et al 1989, Walls-Esquivel, Vecchierini et al 2007, van Putten 2009, Perivier, Roze et al 2016. EEG electrodes, typically placed on the scalp, record the electrophysiological activity of the brain, predominantly of the cerebral cortex (Mizrahi, Hrachovy et al 2004, van Putten 2009, Niedermeyer, Schomer et al 2011.…”

“…To my knowledge, this thesis is the first study to investigate the relationship between qEEG and outcomes, both as continuous variables. Most studies focus on the binary classification of visually inspected EEG activity and clinical outcome, i.e., the relationship between normal/abnormal EEG and normal/abnormal clinical outcome (Selton, Andre et al 2013, Perivier, Roze et al 2016. This divides the cohort into sub groups and focuses only on the binary/categorical investigation, i.e., how many infants with abnormal EEG have abnormal outcome, rather than the relationship between EEG and outcome.…”