Early amplitude-integrated electroencephalography predicts brain injury and neurological outcome in very preterm infants.
Early amplitude-integrated electroencephalography (aEEG) has been widely used in term infants with brain injury to predict neurodevelopmental outcomes; however, the prognostic value of early aEEG in preterm infants is unclear. We evaluated how well early aEEG could predict brain damage and long-term neurodevelopmental outcomes in very preterm infants compared with brain imaging assessments. We found that severe aEEG abnormalities (p=0.000) and aEEG total score<5 (p=0.006) within 72 h after birth were positively correlated with white-matter damage, but aEEG abnormalities were not associated with intracranial hemorrhage (p=0.186). Severe abnormalities in aEEG recordings, head ultrasound, and cranial magnetic resonance imaging (MRI) were all positively correlated with poor outcome at 18 months corrected age. The predictive power of poor outcomes of the aEEG and MRI combination was the same as the aEEG, MRI, and head ultrasound combination with a sensitivity of 52.4%, specificity of 96.2%, positive predictive value of 78.6%, and negative predictive value of 88.4%. These results indicate that severely abnormal aEEG recordings within 72 h after birth can predict white-matter damage and long-term poor outcomes in very preterm infants. Thus aEEG can be used as an early marker to monitor very preterm infants.
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Juan
J
Song
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.|The Laboratory of Neonatal Brain Injury of Henan Province, Zhengzhou, China.
Falin
F
Xu
Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Laishuan
L
Wang
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Liang
L
Gao
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Jiajia
J
Guo
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Lei
L
Xia
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Yanhua
Y
Zhang
Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Wenhao
W
Zhou
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.|Perinatal Center, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Xiaoyang
X
Wang
Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.|The Laboratory of Neonatal Brain Injury of Henan Province, Zhengzhou, China.|Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, 40503, Sweden.
Changlian
C
Zhu
D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D063868:Patient Outcome Assessment; D011379:Prognosis; D012720:Severity of Illness Index; D014463:Ultrasonography