Related Experiment Video
Updated: May 22, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Early single-channel aEEG/EEG predicts outcome in very preterm infants
Sverre Wikström1, Ingrid Hansen Pupp, Ingmar Rosén
1Department of Women's and Children's Health, Uppsala University, Sweden. sverre.wikstrom@liv.se
Insights
Early amplitude-integrated electroencephalogram (aEEG) and EEG in very preterm infants can predict long-term neurodevelopmental outcomes with high accuracy by 24 hours. This method offers a reliable tool for assessing very preterm infants and guiding early interventions.
Area of Science:
- Neonatal Neurology
- Neurodevelopmental Pediatrics
- Clinical Neurophysiology
Background:
- Very preterm (VPT) infants face significant risks of adverse neurodevelopmental outcomes.
- Early prediction of long-term outcomes is crucial for timely intervention and improved care.
- Amplitude-integrated electroencephalogram (aEEG) and conventional EEG offer insights into neonatal brain function.
Purpose of the Study:
- To evaluate the predictive value of early aEEG/EEG patterns for long-term neurodevelopmental outcomes in very preterm infants.
- To determine the optimal timing for aEEG/EEG analysis for outcome prediction.
Main Methods:
- A cohort of 49 very preterm infants (gestational age 22-30 weeks) underwent aEEG/EEG monitoring within the first 72 hours of life.
- EEG data were analyzed for background patterns, sleep-wake cycling, seizures, interburst intervals (IBI), and interburst percentage (IB%).
- Neurological examinations and Bayley Scales of Infant Development-II were performed at 2 years corrected age to assess outcomes.
Main Results:
- Poor neurodevelopmental outcome was associated with depressed aEEG/EEG patterns, prolonged IBI, and higher IB% within the first 24 hours.
- Seizures occurred in 43% of infants but were not directly predictive of outcome.
- Burst-suppression pattern, IBI > 6 sec, and IB% > 55% at 24 hours were the strongest predictors of poor outcome, achieving 74-79% accuracy.
Conclusions:
- Early aEEG/EEG analysis, particularly within 24 postnatal hours, can predict long-term outcomes in very preterm infants with 75-80% accuracy.
- This predictive capability holds true even in infants without early signs of brain injury on ultrasound.
- aEEG/EEG serves as a valuable, non-invasive tool for early risk stratification and management planning in very preterm neonates.
Aim:
To characterize early amplitude-integrated electroencephalogram (aEEG) and single-channel EEG (aEEG/EEG) in very preterm (VPT) infants for prediction of long-term outcome.
Patients:
Forty-nine infants with median (range) gestational age of 25 (22-30) weeks.
Methods:
Amplitude-integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 0-12, 12-24, 24-48 and 48-72 h, for background pattern, sleep-wake cycling, seizures, interburst intervals (IBI) and interburst percentage (IB%). In total, 2614 h of single-channel EEG examined for seizures. Survivors were assessed at 2 years corrected age with a neurological examination and Bayley Scales of Infant Development-II. Poor outcome was defined as death or survival with neurodevelopmental impairment. Good outcome was defined as survival without impairment.
Results:
Thirty infants had good outcome. Poor outcome (n = 19) was associated with depressed aEEG/EEG already during the first 12 h (p = 0.023), and with prolonged IBI and higher IB% at 24 h. Seizures were present in 43% of the infants and associated with intraventricular haemorrhages but not with outcome. Best predictors of poor outcome were burst-suppression pattern [76% correctly predicted; positive predictive value (PPV) 63%, negative predictive value (NPV) 91%], IBI > 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% > 55% at 24 h age (79% correctly predicted; PPV 72%, NPV 80%). In 35 infants with normal cerebral ultrasound during the first 3 days, outcome was correctly predicted in 82% by IB% (PPV 82%, NPV 83%).
Conclusion:
Long-term outcome can be predicted by aEEG/EEG with 75-80% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.
