Abstract
Background Early outcome prediction for preterm infants is inadequate. Discontinuity on early conventional electroencephalography (EEG) is associated with poorer outcomes. However, the complexity of EEG interpretation has limited incorporation into routine clinical practice. Cotside EEG monitors are becoming increasingly available and some produce quantitative measures from the EEG to assist interpretation.
Aim to examine the ability of quantitative measures of continuity from cotside EEG recordings performed on preterm infants in the first four days after birth to predict neurodevelopmental outcome at 18 months.
Methods Preterm infants with birthweights <1500g had cotside EEG monitoring (research BRM, BrainZ Instruments Ltd, Auckland, New Zealand) within four days of birth. Sixty minute portions of EEG were analysed offline for quantitative continuity measures. Continuity was calculated as the percentage of each minute that the EEG amplitude was above a 10, 25 or 50μV threshold and left and right values averaged. Infants had a Bayley-II examination at 18 months chronological age. The relationships between continuity measures and mental/psychomotor developmental indices (MDI/PDI) were explored using simple linear regression. Significant associations were further tested using multiple regression taking into account gestation, birthweight Z score and age at EEG (hours).
Results Forty-four infants were studied with a median (range) gestation of 26(24–31)weeks and birthweight of 925(540–1360)grams. EEG recordings were performed at a median (range) of 26(3–92)hours after birth. Average continuity was related to PDI at each threshold (10μV r-squared=0.21, p=0.0018; 25μV r-squared=0.17, p=0.0048 and 50μV r-squared=0.16, p=0.0067) and to MDI at the 10 and 25μV thresholds (r-squared=0.19, p=0.0032 and r-squared=0.10, p=0.04 respectively). In multiple linear regression analyses continuity at the 10μV threshold remained an independent predictor of PDI (r-squared=0.47, p=0.05) and MDI (r-squared=0.26, p=0.009).
Conclusion Cotside monitoring devices with automated quantitative neurophysiologic analyses may assist clinicians with earlier prediction of neurodevelopmental outcomes in preterm infants. MB is a consultant for BrainZ Instruments Ltd.
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West, C., Battin, M., Williams, C. et al. 413 Early Quantitative Electroencephalographic Measures of Continuity are Associated with Neurodevelopmental Outcome at 18 Months in Preterm Infants. Pediatr Res 58, 425 (2005). https://doi.org/10.1203/00006450-200508000-00442
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DOI: https://doi.org/10.1203/00006450-200508000-00442