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Updated: Jun 4, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
aEEG in the first 3 days after extremely preterm delivery relates to neurodevelopmental outcomes
Roberta Pineda1,2,3,4, Zachary Vesoulis5, Nathalie El Ters5
1Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA. bobbi.pineda@chan.usc.edu.
Insights
Early amplitude-integrated electroencephalography (aEEG) in extremely preterm infants is linked to medical and social factors. Lower aEEG scores correlate with poorer neurodevelopmental outcomes, including executive function, at school age.
Area of Science:
- Neonatal neurology
- Developmental neuroscience
- Clinical neurophysiology
Background:
- Amplitude-integrated electroencephalography (aEEG) is a valuable tool for monitoring brain activity in neonates.
- Extremely preterm infants (<28 weeks gestation) are at high risk for neurological complications.
- Understanding early brain development patterns can inform long-term outcomes.
Purpose of the Study:
- To investigate the associations between early aEEG patterns (first 72 hours) in extremely preterm infants and various infant, medical, and environmental factors.
- To examine the relationship between early aEEG and infant feeding and neurobehavioral outcomes at term-equivalent age and school-age.
Main Methods:
- Sixty-four extremely preterm infants (≤28 weeks gestation) underwent two-channel aEEG monitoring within 24 hours of birth for the first 72 hours.
- Standardized neurobehavioral assessments (e.g., NICU Network Neurobehavioral Scale) and feeding evaluations were performed at term-equivalent age.
- Parent-reported outcomes, including executive function (e.g., BRIEF), were collected at 5-7 years of age.
Main Results:
- Lower aEEG Burdjalov scores were associated with vaginal delivery, cerebral injury, Black race, and unmarried parents.
- Reduced aEEG scores correlated with lower arousal scores on the NICU Network Neurobehavioral Scale at term-equivalent age.
- Lower aEEG scores predicted poorer executive function, including global executive function, inhibition, working memory, organization, metacognition, and behavioral regulation at school-age.
Conclusions:
- Early aEEG monitoring in extremely preterm infants provides insights into medical and sociodemographic factors.
- aEEG patterns in the first 72 hours are predictive of neurodevelopmental outcomes, particularly executive functions, in later childhood.
- No significant relationships were found between early aEEG and feeding outcomes or sensory processing measures.
Objectives:
Investigate relationships between aEEG in the first 72 h in extremely preterm infants with 1) infant, medical, and environmental factors, and 2) infant feeding and neurobehavioral outcomes at term and school-age.
Methods:
Sixty-four preterm infants (≤28 weeks gestation) were enrolled within the first 24-hours of life and had two-channel aEEG until 72 h of life. Standardized neurobehavioral and feeding assessments were conducted at term, and parent-reported outcomes were documented at 5-7 years.
Results:
Lower aEEG Burdjalov scores (adjusted for gestational age) were related to vaginal delivery (p = 0.04), cerebral injury (p = 0.01), Black race (p < 0.01) and having unmarried parents (p = 0.02). Lower Burdjalov scores related to less NICU Network Neurobehavioral Scale arousal (p = 0.002) at term and poorer BRIEF global executive function (p = 0.004), inhibition (p = 0.007), working memory (p = 0.02), material organization (p = 0.0008), metacognition (p = 0.01), and behavioral regulation (p = 0.02) at 5-7 years. We did not observe relationships of early aEEG to feeding outcomes or sensory processing measures.
Conclusion:
Early aEEG within the first 72 h of life was related to medical and sociodemographic factors as well as cognitive outcome at 5-7 years.
