Comparative estimates of neonatal gestational maturity by electrographic and fetal ultrasonographic criteria

We previously reported a high correlation between electrographic and postmortem neuroanatomic (i.e., sulcal-gyral) estimates of maturity in sick preterm neonates who were clinically abnormal because of neonatal medical illnesses. Electroencephalographic studies have not yet been compared with ultrasonographic measurements in healthy fetuses who subsequently had normal neurodevelopmental outcome. Twenty-five EEG recordings on healthy neonates (28-43 weeks postconceptional age) had EEG estimates of gestational maturity without knowledge of obstetric, neonatal, or ultrasonographic criteria. Thirteen recordings from this cohort were obtained on very premature neonates (i.e., < 32 weeks estimated gestational age). Fetal ultrasonographic determinations of gestational maturity for these 13 subjects were also obtained prior to birth. Ultrasonographic estimates were assigned without knowledge of other clinical data. Gestational age estimates based on electroencephalographic analyses were compared with 5 ultrasonographic estimates of gestational age maturity using multivariate regression (i.e., biparietal diameter, abdominal circumference, femur length, transcerebellar diameter, and head circumference), as well as the mother's last menstrual period. No significant differences were detected between the electrographic and obstetric/ultrasonographic estimates of gestational maturity. An electroencephalographer's assessment of gestational age is as accurate as the fetal ultrasonographic estimates in the asymptomatic preterm neonate whose gestational age is < 32 weeks at birth.