title: Impact of perinatal factors on continuous early monitoring of brain electrocortical activity in very preterm newborns by amplitude-integrated EEG.
abstract: BACKGROUND
  Amplitude-integrated electroencephalogram (aEEG) is increasingly used for neuromonitoring in preterms. We aimed to quantify the effects of gestational age (GA), postnatal age (PNA), and other perinatal factors on the development of aEEG early after birth in very preterm newborns with normal cerebral ultrasounds.
  
  
  METHODS
  Continuous aEEG was prospectively performed in 96 newborns (mean GA: 29.5 (range: 24.4-31.9) wk, birth weight 1,260 (580-2,120) g) during the first 96 h of life. aEEG tracings were qualitatively (maturity scores) and quantitatively (amplitudes) evaluated using preestablished criteria.
  
  
  RESULTS
  A significant increase in all aEEG measures was observed between day 1 and day 4 and for increasing GA (P < 0.001). The effect of PNA on aEEG development was 6.4- to 11.3-fold higher than that of GA. In multivariate regression, GA and PNA were associated with increased qualitative and quantitative aEEG measures, whereas small-for-GA status was independently associated with increased maximum aEEG amplitude (P = 0.003). Morphine administration negatively affected all aEEG measures (P < .05), and caffeine administration negatively affected qualitative aEEG measures (P = 0.02).
  
  
  CONCLUSIONS
  During the first few days after birth, aEEG activity in very preterm infants significantly develops and is strongly subjected to the effect of PNA. Perinatal factors may alter the early aEEG tracing and interfere with its interpretation.
authors.affiliation: 1] Department of Neonatology, Zurich University Hospital, Zurich, Switzerland [2] Child Development Centre, Zurich University Children's Hospital, Zurich, Switzerland.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Natalucci
authors.affiliation: Department of Neonatology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hagmann
authors.affiliation: Department of Pediatric Intensive Care and Neonatology, Zurich University Children's Hospital, Zurich, Switzerland.
authors.forename: Vera
authors.initials: V
authors.lastname: Bernet
authors.affiliation: Department of Neonatology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.affiliation: Centre Universitaire Hospitalier Vaudois and University of Lausanne, Statistical Unit, Institute of Social and Preventive Medicine, Lausanne, Switzerland.
authors.forename: Valentin
authors.initials: V
authors.lastname: Rousson
authors.affiliation: Child Development Centre, Zurich University Children's Hospital, Zurich, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
mesh_terms: D000367:Age Factors; D001921:Brain / Q000502:physiology*; D004569:Electroencephalography; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D064926:Neurophysiological Monitoring / Q000379:methods*; D010500:Perinatology / Q000379:methods* / Q000639:trends; D011446:Prospective Studies