Related Experiment Video
Updated: Mar 8, 2026
Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates
Published on: September 6, 2017
Prognostic Accuracy of Electroencephalograms in Preterm Infants: A Systematic Review
Emilie Pi Fogtmann1, Anne Mette Plomgaard2, Gorm Greisen2
1Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark empifo@gmail.com.
Insights
Electroencephalogram (EEG) background activity, including amplitude-integrated EEG (aEEG), recorded early in preterm infants can predict neurodevelopmental outcomes. Abnormal EEG patterns show potential for identifying infants at risk for adverse outcomes.
Area of Science:
- Neonatal Neurology
- Neurodevelopmental Pediatrics
- Clinical Neurophysiology
Background:
- Brain injury is a significant concern in preterm infants, necessitating reliable predictors of long-term neurodevelopmental outcomes.
- Early identification of neurodevelopmental risks is crucial for timely intervention in preterm populations.
Purpose of the Study:
- To evaluate the prognostic accuracy of early EEG background activity, specifically amplitude-integrated EEG (aEEG) and conventional EEG, in predicting neurodevelopmental outcomes in preterm infants.
- To synthesize evidence from observational studies on the predictive value of early EEG for later neurodevelopmental status.
Main Methods:
- A systematic literature search was conducted across major databases including Cochrane Library, PubMed, Embase, and CINAHL.
- Included studies involved preterm infants with EEG/aEEG recordings within 7 days of birth and reported neurodevelopmental outcomes at 1-10 years.
- Data extraction was performed independently by two reviewers, focusing on participants, prognostic tests, and outcomes.
Main Results:
- Thirteen observational studies comprising 1181 preterm infants were analyzed.
- A meta-analysis of 3 studies (267 infants) indicated that abnormal aEEG background activity predicts adverse outcomes.
- The pooled sensitivity and specificity for predicting a developmental quotient <70, cerebral palsy, or death were 0.83 (95% CI, 0.69-0.92) and 0.83 (95% CI, 0.77-0.87), respectively.
Conclusions:
- Early EEG/aEEG recordings in preterm infants show potential as prognostic tools for neurodevelopmental outcomes.
- All included studies had a high risk of bias, and significant heterogeneity was observed.
- High-quality research is required to confirm these findings, and current prognostic value should be considered a scientific tool.
Context:
Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant.
Objective:
To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants for predicting neurodevelopmental outcome.
Data Sources:
The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature.
Study Selection:
We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported neurodevelopmental outcomes 1 to 10 years later.
Data Extraction:
Two reviewers independently performed data extraction with regard to participants, prognostic testing, and outcomes.
Results:
Thirteen observational studies with a total of 1181 infants were included. A meta-analysis was performed based on 3 studies (267 infants). Any aEEG background abnormality was a predictor of abnormal outcome. For prediction of a developmental quotient <70 points, cerebral palsy, or death, the pooled sensitivity was 0.83 (95% confidence interval, 0.69-0.92) and specificity 0.83 (95% confidence interval, 0.77-0.87).
Limitations:
All studies were at high risk of bias. Heterogeneity was evident among the studies with regard to the investigated aEEG and EEG variables, neurodevelopmental outcomes, and cutoff values.
Conclusions:
aEEG or EEG recorded within the first 7 days of life in preterm infants may have potential as a predictor for later neurodevelopmental outcome. We need high-quality studies to confirm these findings. Meanwhile, the prognostic value of aEEG and EEG should be used only as a scientific tool.
