Early amplitude integrated electroencephalography and outcome of very low birth weight infants.

OBJECTIVE

Amplitude integrated electroencephalography (aEEG) has been used in neonates in various clinical and research applications. We hypothesized that an abnormal aEEG score could be used as a predictor of short-term adverse outcome.

METHODS

Very low birth weight infants were enrolled in a prospective observational cohort study. Two channel 12-hour continuous aEEG recordings were performed within 48 h of life and at 1 week of age. Recordings were classified as abnormal if they correspond to a 2 point difference in score. Short-term adverse outcome was defined as either death or Bayley scales ≤ 70 at 4 months corrected age.

RESULTS

One hundred infants were enrolled. Their average gestational age was 27.9 ± 2.6 weeks and average birth weight was 997 ± 299 gram. Fifteen enrolled infants died, one was withdrawn, 29 lost to follow up, and 55 examined at 4 months. Those with adverse outcome had significantly increased percentages of abnormal EEG at 1 week of life (31% vs. 8%), severe intraventricular hemorrhage (IVH) (27% vs. 4.5%), intubation in the delivery room (45% vs. 16%), and increased average days of mechanical ventilation (16 days vs. 4 days). Combining abnormal aEEG at 1 week of life to severe IVH on early head ultrasound increased the sensitivity of ultrasound to detect short-term adverse outcome from 27% to 50%.

CONCLUSION

aEEG is feasible in premature infants and when its data at 1 week of life are combined with early head ultrasound, sensitivity for detecting short-term adverse outcomes was increased.