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Published on: September 6, 2017
Amplitude-integrated electroencephalography can predict neurodevelopmental outcome at 12 months of corrected age in
Elisabeth Ralser1, Vera Neubauer1, Ulrike Pupp-Peglow1
1Department of Paediatrics II, Neonatology, Innsbruck Medical University, Innsbruck, Austria.
Insights
Amplitude-integrated electroencephalography (aEEG) reliably predicts neurodevelopmental outcomes in very preterm infants. Early aEEG assessment using the Burdjalov score provides crucial prognostic information for clinical practice.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Clinical neurophysiology
Background:
- Predicting neurodevelopmental outcomes in very preterm infants is challenging.
- Reliable diagnostic tools are needed for early intervention.
- Amplitude-integrated electroencephalography (aEEG) is a non-invasive monitoring technique.
Purpose of the Study:
- To evaluate the predictive value of aEEG for neurodevelopmental outcomes at 12 months corrected age in preterm infants.
- To assess the utility of the Burdjalov score derived from aEEG.
- To determine the optimal timing for aEEG assessment.
Main Methods:
- A cohort of 232 preterm infants (gestational age 29.5 weeks) was studied.
- Amplitude-integrated electroencephalography was assessed using the Burdjalov score within 18-24 hours of life.
- Neurodevelopmental outcomes were evaluated at 12 months corrected age using the Bayley Scales of Infant Development - Second Edition.
Main Results:
- Lower Burdjalov scores correlated with increased severity of neurodevelopmental delays (moderate and severe).
- The highest predictive accuracy (AUC 0.776) for the Burdjalov score was observed in the first 18-24 hours of life.
- The study identified distinct subgroups based on outcome severity.
Conclusions:
- Amplitude-integrated electroencephalography, particularly the Burdjalov score, demonstrates significant predictive value for neurodevelopmental outcomes in very preterm infants.
- Early aEEG assessment (18-24 hours of life) is recommended for reliable prognostication.
- This non-invasive method can aid in guiding clinical management and early interventions for preterm infants.
Aim:
It is difficult to find diagnostic tools than can reliably predict neurodevelopmental outcomes in very preterm infants in clinical practice. This study evaluated whether amplitude-integrated electroencephalography predicted neurodevelopmental outcome in preterm infants when they reached 12 months of corrected age.
Methods:
Between October 2007 and December 2013, we studied 232 preterm infants (51% male) at Innsbruck Medical University Hospital, Austria. Their mean birthweight was 1264 g, and their mean gestational age was 29.5 weeks. Amplitude-integrated electroencephalography was evaluated using the Burdjalov score, and outcomes were assessed using the Bayley Scales of Infant Development - Second Edition.
Results:
The cohort was divided into three subgroups: 154 infants with normal outcomes, 53 infants with moderate delays and 25 infants with severe delays. The amplitude-integrated electroencephalography Burdjalov scores were lower in infants with moderate delays than in infants with normal outcomes and even lower in infants with severe delays. The highest area under the curve (0.776) for the Burdjalov score was at 18-24 hours of life.
Conclusion:
Our study confirmed the predictive value of amplitude-integrated electroencephalography and showed that this needed to be carried out early in life to provide reliable information on neurodevelopmental outcomes in very preterm infants.
