Predictive value of an early amplitude-integrated electroencephalogram for short-term neurologic outcomes in preterm infants

Background and objectives. The aim of this study was to compare serial scores of amplitude-integrated electroencephalography (aEEG) in preterm infants with favorable neurologic outcome compared with those with unfavorable neurologic outcome and to evaluate whether aEEG in the early days of life has predictive value for short-term neurologic outcome in preterm infants. Methods. This prospective observational study included infants born at ≤32 weeks of gestational age and ≤1,500 g of birth weight. On the basis of brain ultrasonography findings, the infants were divided into two groups (favorable and unfavorable outcome group) at 36 weeks of corrected age or at discharge. aEEG was performed at 12-14 h (day-1), 46-48 h (day-2), 70-72 h (day-3), and 1 week (day-7) of life. The aEEG recordings were analyzed using the criteria described by Burdjalov et al.23 and the serial scores of aEEG were compared between the two groups. Results. Thirty five infants were enrolled and 18 infants and 17 infants were identified into both groups, respectively. Infants in the favorable outcome group showed high scores in almost all parameters and the score of all parameters increased over time. However, the scores of all components decreased in day-2 compared with those of day 1 in the unfavorable outcome group. The total score less than 3 of day-2 has predictive value of 70.6% of sensitivity and 72.2% of specificity for unfavorable outcome. Conclusion. We found that aEEG is a useful predictor for short-term neurologic outcome in preterm infants.

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1. Blaymore-Bier J, Pezzullo J, Kim E, Oh W, Garcia- Coll C, Vohr BR. Outcome of extremely low-birthweight infants: 1980-1990. Acta Paediatr 1994; 83: 1244-1248.

2. La Pine TR, Jackson JC, Bennett FC. Outcome of infants weighing less than 800 grams at birth: 15 years’ experience. Pediatrics 1995; 96: 479-483.

3. Piecuch RE, Leonard CH, Cooper BA, Sehring SA. Outcome of extremely low birth weight infants (500 to 999 grams) over a 12-year period. Pediatrics 1997; 100: 633-639.

4. Olischar M, Klebermass K, Waldhoer T, Polak A, Weninger M. Background patterns and sleep-wake cycles on amplitude-integrated electroencephalography in preterms younger than 30 weeks gestational age with peri-/intraventricular haemorrhage. Acta Paediatr 2007; 96: 1743-1750.

5. Wilson-Costello D, Friedman H, Minich N, Fanaroff AA, Hack M. Improved survival rates with increased neurodevelopmental disability for extremely low birth weight infants in the 1990s. Pediatrics 2005; 115: 997-1003.

6. Tharp BR, Cukier F, Monod N. The prognostic value of the electroencephalogram in premature infants. Electroencephalogr Clin Neurophysiol 1981; 51: 219- 236.

7. Marret S, Parain D, Jeannot E, Eurin D, Fessard C. Positive rolandic sharp waves in the EEG of the premature newborn: a five year prospective study. Arch Dis Child 1992; 67: 948-951.

8. Maruyama K, Okumura A, Hayakawa E, Kato T, Kuno K, Watanabe K. Prognostic value of EEG depression in preterm infants for later development of cerebral palsy. Neuropediatrics 2002; 33: 133-137.

9. Okumura A, Hayakawa F, Kato T, Kuno K, Watanabe K. Developmental outcome and types of chronicstage EEG abnormalities in preterm infants. Dev Med Child Neurol 2002; 44: 729-734.

10. Kato T, Okumura A, Hayakawa F, Kuno K, Watanabe K. Electroencephalographic aspects of periventricular hemorrhagic infarction in preterm infants. Neuropediatrics 2004; 35: 161-166.

11. El-Dib M, Massaro AN, Glass P, et al. Early amplitude integrated electroencephalography and outcome of very low birth weight infants. Pediatr Int 2011; 53: 315-321.

12. Chalak LF, Sikes NC, Mason MJ, Kaiser JR. Low voltage aEEG as predictor of intracranial hemorrhage in preterm infants. Pediatr Neurol 2011; 44: 364-369.

13. Holmes G, Rowe J, Hafford J, Schmidt R, Testa M, Zimmerman A. Prognostic value of the electroencephalogram in neonatal asphyxia. Electroencephalogr Clin Neurophysiol 1982; 53: 60- 72.

14. Obrecht R, Pollock MA, Evans S, Scott DF. Prediction of outcome in neonates using EEG. Clin Electroencephalogr 1982; 13: 46-49.

15. Rowe JC, Holmes GL, Hafford J, et al. Prognostic value of the electroencephalogram in term and preterm infants following neonatal seizures. Electroencephalogr Clin Neurophysiol 1985; 60: 183- 196.

16. van Lieshout HB, Jacobs JW, Rotteveel JJ, Geven W, v’t Hof M. The prognostic value of the EEG in asphyxiated newborns. Acta Neurol Scand 1995; 91: 203-207.

17. Benavente-Fernández I, Lubián-López SP, Jiménez- Gómez G, Lechuga-Sancho AM, Garcia-Alloza M. Low-voltage pattern and absence of sleep-wake cycles are associated with severe hemorrhage and death in very preterm infants. Eur J Pediatr 2015; 174: 85-90.

18. Klebermass K, Olischar M, Waldhoer T, Fuiko R, Pollak A, Weninger M. Amplitude-integrated EEG pattern predicts further outcome in preterm infants. Pediatr Res 2011; 70: 102-108.

19. Reynolds LC, Pineda RG, Mathur A, et al. Cerebral maturation on amplitude-integrated electroencephalography and perinatal exposures in preterm infants. Acta Paediatr 2014; 103: e96-e100.

20. Soubasi V, Mitsakis K, Sarafidis K, Griva M, Nakas CT, Drossou V. Early abnormal amplitude-integrated electroencephalography (aEEG) is associated with adverse short-term outcome in premature infants. Eur J Paediatr Neurol 2012; 16: 625-630.

21. Welch C, Helderman J, Williamson E, O’Shea TM. Brain wave maturation and neurodevelopmental outcome in extremely low gestational age neonates. J Perinatol 2013; 33: 867-871.

22. Wikström S, Pupp IH, Rosen I, et al. Early singlechannel aEEG/EEG predicts outcome in very preterm infants. Acta Paediatr 2012; 101: 719-726.

23. Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates. Pediatrics 2003; 112: 855-861.

24. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92: 529-534.

25. de Vries LS, Eken P, Dubowitz LM. The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res 1992; 49: 1-6.

26. Kidokoro H, Kubota T, Hayashi N, et al. Absent cyclicity on aEEG within the first 24 h is associated with brain damage in preterm infants. Neuropediatrics 2010; 16: 241-245.

27. Sohn JA, Kim HS, Lee EH, et al. Developmental change of amplitude-integrated electroencephalographic activity in preterm infants with intraventricular hemorrhage. Early Hum Dev 2013; 89: 961-966.

28. Hellström-Westas L, Rosen I, de Vries LS, Greisen G. Amplitude-integrated EEG classification and interpretation in preterm and term infants. NeoReviews 2006; 7: e76-e87.

29. Bruns N, Dransfeld F, Hüning B, et al. Comparison of two common aEEG classifications for the prediction of neurodevelopmental outcome in preterm infants. Eur J Pediatr 2017; 176: 163-171.

30. Han YM, Lee NR, Bae MH, et al. Establishing reference values for amplitude-integrated electroencephalography in preterms below 35 weeks of gestational age: a prospective observational cohort study. Turk J Pediatr 2016; 58: 592-601.

31. Krägeloh-Mann I, Toft P, Luding J, Andersen J, Pryds O, Lou HC. Brain lesions in preterm: origin, consequences and compensation. Acta Paediatr 1999; 88: 897-908.

32. Volpe JJ. Neurobiology of the periventricular leukomalacia in the premature infant. Pediatr Res 2001; 50: 553-562.

33. Kehrer M, Blumenstock G, Ehehalt S, Goelz R, Poets C, Schöning M. Development of cerebral blood flow volume in preterm neonates during the first two weeks of life. Pediatr Res 2005; 58: 927-930.

34. Bowen JR, Paradisis M, Shah D. Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation. Pediatr Res 2010; 67: 538-544.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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