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Published on: September 6, 2017
Quantitative electroencephalographic patterns in normal preterm infants over the first week after birth
Claire R West1, Jane E Harding, Christopher E Williams
1Liggins Institute, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Insights
Quantitative electroencephalography (EEG) measures show consistent changes in preterm infants during their first week of life. These findings may improve prediction of neurodevelopmental outcomes for premature babies.
Area of Science:
- Neonatal neurophysiology
- Developmental neuroscience
- Clinical electroencephalography
Background:
- Current tools for predicting neurodevelopmental outcomes in preterm infants are insufficient.
- Quantitative electroencephalography (EEG) offers potential for objective electrophysiologic measures.
- These EEG measures may aid in predicting infant neurodevelopmental trajectories.
Purpose of the Study:
- To identify patterns of change in quantitative EEG measures within the first week after birth in preterm infants.
- To establish normative developmental trends in EEG parameters for this population.
Main Methods:
- An observational study design was employed.
- Quantitative EEG data were collected from preterm infants (born <32 weeks gestation) with normal ultrasound scans.
- Changes in EEG continuity, amplitude, and spectral edge frequency were analyzed over the first week post-birth.
Main Results:
- EEG continuity significantly increased from day 1 to day 7 (p<0.0001) in preterm infants.
- Median EEG amplitude showed a significant increase by day 4 (p=0.005).
- A trend towards decreasing spectral edge frequency was observed by day 3 (p=0.06).
Conclusions:
- Consistent changes in quantitative neurophysiologic measures, especially continuity, occur in the first week of life for preterm infants.
- These developmental EEG patterns provide a baseline for assessing neurodevelopmental status.
- Findings support the utility of quantitative EEG in monitoring preterm infant brain development.
Background:
Currently available tools to assist clinicians with prediction of neurodevelopmental outcome of preterm infants are inadequate. Modified cotside electroencephalography (EEG) has the ability to produce quantitative electrophysiologic measures. These measures may be useful in future prediction of outcome.
Aim:
To determine patterns of change in quantitative EEG measures in preterm infants during their first week after birth.
Design:
Observational.
Subjects:
Preterm infants born at less than 32 weeks completed gestation surviving to discharge with unremarkable serial ultrasound scans.
Outcome Measures:
Changes in continuity, amplitude and spectral edge frequency measures of EEGs obtained over the first week after birth.
Results:
Results of EEGs performed using a novel EEG device on 63 infants are reported here. Their median (range) gestation was 29 (24-31) weeks and birthweight was 1,235 (540-1,980) g. Quantitative measures of EEG continuity increased over the first week after birth from 72 (25-99)% to 92 (54-100)% at the 25 microV threshold, and from 39 (10-87)% to 64 (34-75)% at the 50 microV threshold, both p<0.0001. There was a related 32% increase in median amplitude from 5.8 (2.6-10.6) microV on day 1 to 7.6 (4.3-9.4) microV on day 4, p=0.005. There was a trend for average spectral edge frequency to fall from 10.7 (9.3-12.9) Hz on day 1 to 9.9 (8.1-12.3) Hz on day 3, p=0.06. Each gestational tertile showed similar patterns.
Conclusions:
There are consistent changes in quantitative neurophysiologic measures over the first week after birth, and particularly measures of continuity over the first 4 days, in normal preterm infants.
