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Can EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?
Rhodri O Lloyd1,2, John M O'Toole1,2, Vicki Livingstone1,2
1INFANT Research Centre, University College Cork, Ireland.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|April 20, 2021
Summary
Serial multichannel electroencephalography (EEG) in preterm infants accurately predicts 2-year neurodevelopmental outcomes. A 35-week postmenstrual age EEG is the strongest predictor, offering valuable prognostication for high-risk infants.
Area of Science:
- Neonatal Neurology
- Neurodevelopmental Pediatrics
- Clinical Neurophysiology
Background:
- Preterm infants face significant risks of adverse neurodevelopmental outcomes.
- Accurate prognostication is crucial for timely intervention and management.
- Current predictive methods like clinical assessments and cranial ultrasounds have limitations.
Purpose of the Study:
- To determine the predictive accuracy of serial multichannel video electroencephalography (EEG) for 2-year neurodevelopmental outcomes in preterm infants.
- To compare the predictive performance of EEG with clinical risk scores and cranial ultrasound findings.
Main Methods:
- Prospective enrollment of infants born <32 weeks gestational age (GA).
- Serial EEGs recorded at three time points: early neonatal period, ~32 weeks, and ~35 weeks postmenstrual age (PMA).
- EEG scoring used an age-specific grading scheme; neurodevelopmental outcome assessed using Bayley Scales of Infant Development III at 2 years corrected age.
Main Results:
- Fifty-seven infants completed follow-up; 17 had abnormal outcomes or died.
- All EEG time points individually predicted abnormal outcomes, with the 35-week PMA EEG showing the highest predictive accuracy (AUC=0.91).
- EEG prediction significantly outperformed clinical course (AUC=0.68) and cranial ultrasound (AUC=0.58).
Conclusions:
- Multichannel EEG, particularly around 35 weeks PMA, is a robust predictor of 2-year neurodevelopmental outcomes in preterm infants.
- Early postnatal EEG can be reassuring if normal, while later EEG aids in prognostication, especially considering postnatal clinical complications.
- EEG offers a valuable tool for identifying preterm infants at high risk for brain injury and guiding clinical management.
