Abstract 140

Background: Neurological outcome may vary significantly in infants with large intra-ventricular haemorrhages (IVH) with similar appearance on cranial ultrasonography. Postmorten studies in preterm infants have shown that the EEG background is better correlated with the number of damaged brain structures than with the degree of IVH.

Aim of study: To investigate whether continuous EEG-monitoring(amplitude-integrated EEG) during the first days of life can predict the degree of handicap in preterm infants with large IVH.

Subjects and Method: Retrospective analysis of aEEG recorded during the first week of life, blinded for outcome, in 27 children aged 3-11 years, born with gestational ages <32 weeks and who survived with IVH grade III-IV. Evaluated EEG-features: Number of min. and max. bursts/hour/day; Presence or absence of seizure activity, sleep-wake-cycling (SWC), and reactivity to handling. Evaluation of handicap: "Good" prognosis = without or with cerebral palsy but able to walk and no mental retardation; "Poor" prognosis = cerebral palsy and unable to walk, and/or mental retardation, and/or blind. Mann-Whitney U-test was used, level of significance p<0.05.

Results: There were significant differences between the two groups ("good" n=18, "poor" n=9) regarding max. bursts/h on days 2,5, and 7; min. bursts/h on days 4-7; reactivity to handling on day 4; and SWC on days 6-7. There were no differences between the groups regarding gestational age, birth weight, inborn/outborn, degree of IVH, or need for ventriculoperitoneal shunt (n=9 vs. n=2).

Conclusion: The degree of subsequent neurological handicap is possible to predict in very preterm infants with large IVH's already during the first days of life. These findings may have implications for the care of preterm infants with IVH, especially regarding future interventional treatment.