Trends in Amplitude-Integrated Electroencephalography in the Smallest Preterm Neonates

Area of Science:

• Neonatal neurology
• Neurophysiology
• Developmental neuroscience

Background:

• Amplitude-integrated electroencephalography (aEEG) is vital for neuromonitoring in premature infants.
• Understanding bioelectrical activity changes in the earliest gestational age newborns remains unclear.
• This study investigates aEEG patterns in relation to gestational and postnatal age in preterm neonates.

Purpose of the Study:

• To evaluate bioelectrical activity using aEEG in premature newborns of varying gestational ages.
• To determine the influence of gestational age and postnatal age on aEEG patterns.
• To test if brain bioelectrical activity matures faster postnatally than in utero.

Main Methods:

• Prospective study of infants born before 32 weeks gestational age (June 2020-July 2022).
• Serial aEEG recordings at three postnatal age points: days 1-3, 13-15, and 27-29.
• Analysis of background patterns, cyclicity, lower amplitude border, and bandwidth to calculate a composite Burdjalov score.

Main Results:

• 140 preterm neonates enrolled; 112 completed the study. Median gestational age: 29 weeks.
• Burdjalov scores positively correlated with gestational age.
• Newborns of lower gestational age showed higher aEEG scores compared to those of higher gestational age at the same postmenstrual age.

Conclusions:

• Higher gestational age positively impacts aEEG bioelectrical activity.
• Postnatal age demonstrated a greater influence on aEEG patterns than gestational age.
• The study confirmed that premature newborns' brain bioelectrical activity matures faster after birth than in utero.