Which aEEG patterns could predict neurodevelopmental outcome in preterm neonates? - A systematic review.

Area of Science:

• Neonatal neurology
• Developmental neuroscience
• Clinical neurophysiology

Background:

• Amplitude-integrated electroencephalogram (aEEG) offers continuous, simplified bedside monitoring of brain function in neonates.
• Predicting neurodevelopmental outcomes in preterm infants is crucial for early intervention and improved care.
• Existing methods for assessing neonatal brain function may be limited in continuous bedside application.

Purpose of the Study:

• To systematically review the literature on the predictive value of aEEG for neurodevelopmental outcomes in preterm infants.
• To synthesize evidence regarding specific aEEG patterns and their association with infant development.
• To evaluate the reliability of aEEG as a prognostic tool in neonatal care.

Main Methods:

• Systematic literature search of PubMed, Embase, and Web of Science databases (April-October 2023) following PRISMA guidelines.
• Inclusion of 19 studies (18 cohort, 1 case-control) involving 2074 preterm neonates.
• Assessment of study quality using the Newcastle-Ottawa Scale (NOS).

Main Results:

• aEEG recordings, often initiated within 72 hours of life, were analyzed for their association with neurodevelopmental outcomes.
• Poor neurodevelopmental outcomes were linked to burst suppression and low voltage background patterns.
• Favorable outcomes correlated with normal background patterns and established cyclicity, particularly when observed within the first week of life.

Conclusions:

• aEEG background patterns and cyclicity demonstrate reliability in predicting neurodevelopmental outcomes for preterm infants.
• Early initiation of aEEG monitoring enhances its predictive accuracy.
• aEEG serves as a valuable, non-invasive tool for prognostication in neonatal intensive care.