Effects of postnatal age and aminophylline on the maturation of amplitude-integrated electroencephalography activity in preterm infants.
BACKGROUND
The use of amplitude-integrated electroencephalography (aEEG) is increasing during the neonatal intensive care of preterm infants.


OBJECTIVE
This prospective study was designed to assess factors that affect the maturation of aEEG activity in preterm infants with a gestational age (GA) of <32 weeks.


METHODS
aEEGs with cerebral function monitoring were performed weekly in preterm infants, and the recordings were evaluated and scored to assess the degree of continuity, the degree of sleep-wake cycling, and the amplitude of the lower border. Subjects with any of the following conditions were excluded: intraventricular hemorrhage or periventricular leukomalacia on cranial ultrasonography, sedation, hypotension, or respiratory instability (FiO(2) >50%).


RESULTS
The authors analyzed 207 recordings in 35 infants (GA 24-31 weeks, birth weight 440-1,980 g, postmenstrual age 25-38 weeks). At postmenstrual age 34-36 weeks, the aEEG total score was higher in preterm infants with a GA from 24 to 28 weeks than in less premature infants with a GA from 29 to 31 weeks (aEEG total score 12 vs. 10, p < 0.05). Logistic regression analysis revealed that the sleep-wake cycling was more prominent in infants with higher postnatal age (OR 3.32, 95% CI 2.40-4.59) or those receiving aminophylline (OR 3.28, 95% CI 1.06-10.08).


CONCLUSIONS
The maturation of aEEG activity was found to be significantly correlated with postnatal age and with aminophylline use in clinically stable preterm infants. Most notably, aminophylline was found to be significantly associated with the degree of sleep-wake cycling as indicated by aEEG activity.
Lee
Hyun Ju
HJ
Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Kim
Han-Suk
HS
Kim
Se-Yeon
SY
Sim
Gue Hong
GH
Kim
Eun Sun
ES
Choi
Chang Won
CW
Kim
Ee-Kyung
EK
Kim
Beyong Il
BI
Choi
Jung-Hwan
JH
D000367:Age Factors; D000628:Aminophylline / Q000494:pharmacology* / Q000627:therapeutic use; D001724:Birth Weight / Q000187:drug effects; D001921:Brain / Q000187:drug effects* / Q000254:growth & development / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D004453:Echoencephalography; D004569:Electroencephalography / Q000187:drug effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D058915:Purinergic P1 Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use
D058915:Purinergic P1 Receptor Antagonists; D000628:Aminophylline