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Updated: Feb 19, 2026
Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates
Published on: September 6, 2017
Establishing reference values for amplitude-integrated electroencephalography in preterms below 35 weeks of
Young Mi Han1, Na Rae Lee1, Mi Hye Bae1
1Division of Neonatology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Insights
Amplitude-integrated electroencephalography (aEEG) patterns help assess brain maturation in preterm infants. This study establishes approximate reference values for aEEG development in premature infants during their first week of life.
Area of Science:
- Neonatal Neurology
- Neurophysiology
- Developmental Pediatrics
Background:
- Amplitude-integrated electroencephalography (aEEG) shows characteristic patterns correlating with gestational age (GA), aiding brain maturation assessment in premature infants.
- Limited reference data exists for normal aEEG values in preterm infants, hindering accurate interpretation.
- Validation of existing aEEG scoring systems and establishment of normative data are crucial for clinical application.
Purpose of the Study:
- To validate a current aEEG scoring system (Burdjalov criteria) for assessing brain maturation in preterm infants.
- To investigate the developmental trajectory of aEEG activity within the first week post-birth.
- To determine approximate reference values for aEEG in preterm infants without abnormal cranial ultrasound findings.
Main Methods:
- Prospective study of infants with GA < 35 weeks, including serial aEEG recordings and cranial ultrasounds.
- aEEG recordings were performed at four time points: 12-14h, 46-48h, 70-72h, and 1 week post-birth.
- aEEG tracings were scored by two independent neonatologists using Burdjalov criteria, with analysis of inter-rater agreement and score progression.
Main Results:
- Thirty-four preterm infants (GA 24-35 weeks) completed the study, with 134 aEEG tracings analyzed.
- High inter-rater agreement (mean difference -0.05) was achieved for aEEG scoring.
- aEEG scores demonstrated a gradual increase with advancing gestational and postnatal age, with highest scores observed at 35 weeks GA.
Conclusions:
- The study provides approximate reference values for aEEG development in preterm infants, supporting its use in assessing brain maturation.
- The validated scoring system shows high reliability among raters.
- Further research with larger cohorts and longer follow-up is recommended to establish standardized aEEG reference criteria.
Abstract:
Characteristic patterns in amplitude-integrated electroencephalography (aEEG) develop with gestational age (GA), and so can be used to evaluate brain maturation in premature infants. Reference aEEG values in normal preterm infants have not been identified and data are scarce. We aimed to validate a currently available aEEG scoring system. We also investigated the development of aEEG activity during the first week after birth, determining reference values in preterm infants with no abnormal cranial ultrasound findings. We prospectively studied aEEG and cranial ultrasounds in infants with a GA of < 35 weeks. We conducted aEEG at 12-14 hours, 46-48 hours, 70-72 hours, and 1 week after birth. The aEEG recordings were evaluated using Burdjalov criteria, scored by two independent neonatologists. Thirty-four infants were enrolled and completed the 1-week evaluation. GA ranged from 24 to 35 weeks and birth weights varied between 570 and 2,100 g. We analyzed 134 aEEG tracings, with a mean difference between raters of -0.05. Total scores, summed from scores for each assessed variable, increased gradually with advancing gestational and postnatal age. However, highest scores were not attained until 35 weeks' gestational age. There was high inter-rater agreement for aEEG scoring, and we could ascertain some approximate reference values for aEEG development in preterm infants at varying GA. To establish standardized aEEG reference criteria, further studies in larger cohorts of premature infants should be performed over longer periods.
