Differences in the Maturation of Amplitude-Integrated EEG Signals in Male and Female Preterm Infants

Abstract

Background: The amplitude-integrated electroencephalogram (aEEG) is a valuable tool for monitoring brain function in preterm infants. Several studies have discussed sex-related differences regarding neonatal morbidity and mortality. To date, no study has been published specifically evaluating potential sex-related differences in aEEG parameters. Objective: The aim of this study was to assess sex-related differences in aEEG signals in preterm born infants without brain injury in the first 4 weeks of life. Methods: aEEG was performed at seven time points (days 1, 2, 3, weeks 1, 2, 3 and 4) and analyzed for Burdjalov total score, number of bursts per hour and visual background pattern. Patients: One hundred and fifty-six infants (85 male and 71 female) born with a gestational age between 28 and 31 completed weeks were evaluated. Results: Mean total score increased with postnatal age and ranged from 5.4 at day 1 to 11.0 at the end of the study period. The score was higher for girls at every time point, and the mean difference was between 0.3 and 0.9. The number of bursts per hour decreased over time from 8.9 at day 1 to 1.6 at the end of the study period. At week 4, the number of bursts per hour was significantly lower in girls (1.3) than in boys (2.0). Conclusion: Sex-related differences were present in aEEG signals of preterm infants. The lower total score and the higher number of bursts might express delayed brain maturation in male preterm infants.

Applying a data-driven approach to quantify EEG maturational deviations in preterms with normal and abnormal neurodevelopmental outcomes

“… (normal outcome) the effect of gender on the maturation of some of the features defined in this study (including Line Length Burst%) and did not find a significant gender effect in this group with normal neurodevelopmental outcome 55 . Griesmaier et al (2014) did find sex-related differences in the maturation of amplitude-integrated EEG signals during the first four weeks, however, these results were not correlated with outcome 56 . In future studies with larger data sizes, it would be of major interest to delineate whether sex-related differences in maturational trajectories can be observed and whether these altered neurophysiological mechanisms can be related to long-term outcomes.…”

Early amplitude-integrated electroencephalography predicts brain injury and neurological outcome in very preterm infants

“…The optimal time after birth for taking aEEG recordings to predict adverse outcomes is still unclear 17 18 24 . Recent studies have assessed aEEG recordings within 72 h after birth and found reasonable predictive value for these aEEG recordings in predicting poor outcomes 18 22 25 . Preterm infants are most vulnerable to high-risk perinatal factors within the first 72 h after birth, and most ICH in preterm infants occurs during this period of time 12 .…”

Secretoneurin Serum Levels in Healthy Term Neonates and Neonates with Hypoxic-Ischaemic Encephalopathy

“…Images were reviewed for the presence of abnormal signal intensity in the basal ganglia, thalami, posterior limb of the internal capsule and the white matter and cortex [18]. Amplitude-integrated electroencephalography (aEEG) was recorded for the first 72-96 h with the BRM3 monitor (BrainZ Instruments, Natus Medical Inc., San Carlos, Calif., USA) as described previously [19] and analysed for background pattern, presence of sleep-wake cycling and seizure activity. Before discharge and at the age of 3 months, a detailed neurological examination was performed.…”