A standardised assessment scheme for conventional EEG in preterm infants
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Updated: Jan 2, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Elena Pavlidis1, Rhodri O Lloyd1, Vicki Livingstone1
1INFANT Centre for Maternal and Child Health Research, Ireland; Department of Pediatrics and Child Health, University College Cork, Cork, Ireland.
Insights
A new standardized electroencephalography (EEG) assessment scheme for preterm infants shows high interobserver agreement, aiding brain activity monitoring in Neonatal Intensive Care Units.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Developmental neuroscience
Background:
- Electroencephalography (EEG) is crucial for assessing brain activity and maturation in preterm infants.
- Standardized assessment tools are needed to improve the reliability of EEG interpretation in Neonatal Intensive Care Units (NICUs).
Purpose of the Study:
- To develop a standardized scheme for evaluating normal and abnormal electroencephalography (EEG) features in preterm infants.
- To assess the interobserver agreement of this newly developed EEG assessment scheme.
Main Methods:
- A standardized EEG assessment scheme was created for 6 post-menstrual age (PMA) groups and 4 EEG categories.
- Two independent experts evaluated EEG epochs from preterm infants (<32 and <37 weeks gestational age).
- Interobserver agreement was calculated based on the ratio of agreements to total assessments.
Main Results:
- The scheme demonstrated good interobserver agreement across all patients and EEG feature categories, with a median agreement of 80%–100%.
- No significant difference in agreement rates was observed between normal and abnormal EEG features (p=0.959).
Conclusions:
- A standardized EEG assessment scheme for preterm infants has been successfully developed.
- The scheme exhibits good interobserver agreement, supporting its utility in clinical settings.
Objective:
To develop a standardised scheme for assessing normal and abnormal electroencephalography (EEG) features of preterm infants. To assess the interobserver agreement of this assessment scheme.
Methods:
We created a standardised EEG assessment scheme for 6 different post-menstrual age (PMA) groups using 4 EEG categories. Two experts, not involved in the development of the scheme, evaluated this on 24 infants <32 weeks gestational age (GA) using random 2 hour EEG epochs. Where disagreements were found, the features were checked and modified. Finally, the two experts independently evaluated 2 hour EEG epochs from an additional 12 infants <37 weeks GA. The percentage of agreement was calculated as the ratio of agreements to the sum of agreements plus disagreements.
Results:
Good agreement in all patients and EEG feature category was obtained, with a median agreement between 80% and 100% over the 4 EEG assessment categories. No difference was found in agreement rates between the normal and abnormal features (p = 0.959).
Conclusions:
We developed a standard EEG assessment scheme for preterm infants that shows good interobserver agreement.
Significance:
This will provide information to Neonatal Intensive Care Unit (NICU) staff about brain activity and maturation. We hope this will prove useful for many centres seeking to use neuromonitoring during critical care for preterm infants.
