Prognostic value of amplitude‐integrated EEG in neonates with high risk of neurological sequelae

Abstract

Objective To determine the efficacy and the prognostic value of amplitude‐integrated electroencephalography (aEEG) in term and near‐term neonates with high risk of neurological sequelae. Methods Infants of ≥35 weeks of gestation diagnosed with neonatal encephalopathy or with high risk of brain injury were included. All eligible infants underwent aEEG within 6 h after clinical assessment. The infants were followed up 12 months to evaluate neurological development. Results A total of 250 infants were eligible, of which 85 had normal aEEG, 81 had mildly abnormal aEEG, and 84 had severely abnormal aEEG. Of these infants, 168 were diagnosed with different neonatal encephalopathies, 27 with congenital or metabolic diseases, and 55 with high risk of brain injury. In all, 22 infants died, 19 were lost to follow‐up, and 209 completed the follow‐up at 12 months, of which 62 were diagnosed with a neurological disability. Statistical analysis showed that severely abnormal aEEG predicted adverse neurological outcome with a sensitivity of 70.2%, a specificity of 87.1%, a positive predictive value of 75.6%, and a negative predictive value of 83.7%. Interpretation aEEG can predict adverse outcomes in high‐risk neonates and is a useful method for monitoring neonates with high risk of adverse neurological outcomes.

Iatrogenic vs. Spontaneous Preterm Birth: A Retrospective Study of Neonatal Outcome Among Very Preterm Infants

“…GA was established based on first-trimester ultrasound estimations in the majority of patients and in a few patients by the last menstrual bleeding before pregnancy. The following parameters were included in the analysis: small for gestational age (SGA, defined as birth weight < 10th percentile for gestational age), asphyxia ( 14 ), bronchopulmonary dysplasia (BPD, defined simply by considering the need for oxygen at 28 days after birth) ( 15 ), pneumonia, anemia ( 16 ), patent ductus arteriosus ( 17 ), persistent pulmonary hypertension ( 18 ), coagulopathy ( 19 ), retinopathy of prematurity ( 20 ), necrotizing enterocolitis (NEC, Bell's stage ≥ II) ( 16 ), intraventricular hemorrhage (IVH, diagnosed by intracranial ultrasound and graded from 1 to 4 on the Papile scale) ( 21 ), periventricular leukomalacia (PVL, diagnosed by intracranial ultrasound or brain magnetic resonance imaging) ( 22 ), pathoglycemia (blood sugar < 2.2 mmol/L or > 7 mmol/L), and neonatal death (died before 28 days of life).…”

“…GA was established based on first-trimester ultrasound estimations in the majority of patients and in a few patients by the last menstrual bleeding before pregnancy. The following parameters were included in the analysis: small for gestational age (SGA, defined as birth weight < 10th percentile for gestational age), asphyxia (14), bronchopulmonary dysplasia (BPD, defined simply by considering the need for oxygen at 28 days after birth) (15), pneumonia, anemia (16), patent ductus arteriosus (17), persistent pulmonary hypertension (18), coagulopathy (19), retinopathy of prematurity (20)…”

Early Diagnosis of Brain Injury in Premature Infants Based on Amplitude-Integrated EEG Scoring System

“…Sleep-wake cycles can be seen in babies who are in good condition at 25-26 weeks of gestational age [ 10 ]. Starting from 30 to 31 weeks, the QS period can be clearly distinguished on the aEEG graph, which is manifested as an increase in bandwidth, which lasts 20–30 minutes [ 11 ]. The classification system created by related scholars classifies the results of aEEG into 3 categories according to the upper boundary, lower boundary amplitude, and presence or absence of epileptiform activity.…”

Risk Factors for Clinical Seizures in Neonates with Hypoxic–ischemic Encephalopathy Treated with Therapeutic Hypothermia

“…Severity of aEEG correlates with subsequently developing clinical seizures in neonates with HIE 6 16 . The risk of developing epilepsy within 12 months after birth is 12% in infants with severely abnormal aEEG 37 . In the present study, aEEG was severely abnormal in 53.3% of the infants with clinical seizures.…”