Abstract
Background: With increase in the incidence of preterm birth, quality of life in premature infants who suffer from perinatal brain injury has become a major concern. Amplitude electroencephalogram has the advantages of being simple bedside monitoring for assessment of brain function and follow up in preterm neonates. Aim of Study: To evaluate the aEEG changes in preterm infants and compare it to cranial ultrasound. Patients and Methods: This was a prospective observational study conducted at the NICU of Al Zahraa University Hospital for a period from May 2020 to May 2021. Our study was conducted on 60 preterm infants (26 - 36 w) in the first 7 days of life with exclusion of obvious congenital anomalies and hypoxic ischemic encephalopathy patients. Cranial ultrasound was performed on all the studied groups then aEEG recording was done for 4 hours. Results: The pattern of aEEG was discontinuous in patients with low gestational age and in infants small for gestational age. The pattern was also discontinuous in infants who had convulsions. Among our studied infants who had PROM, pre-eclampsia and experienced prolonged delivery, some infants had low voltage amplitude recording as well as infants with intraventricular hemorrhage grade III. Conclusion: This study confirms that aEEG background activity is strongly related to gestational age, birth weight, convulsions and IVH. Complications during delivery alter neonatal brain activity and aEEG background. Early aEEG combined with cranial ultrasound increases the sensitivity for detecting abnormal neurological outcome.
Highlights
We had 60 preterm infants enrolled in the study, 40% were females and 60% were males, their mean gestational age was 32.9 ± 2.1, with postnatal age ranged from 4.4 ± 1.1, most of the infants were delivered by cesarean section 55%
85% were appropriate for GA with mean 2.6 ± 0.23 while 15% were small for gestational age (SGA) with mean 2.2 ± 0.35
The amplitude was normal in 80% while it was low in 20%. Amplitude EEG (aEEG) detected silent convulsions in 55% of the patients
Summary
AEEG has been widely used to monitor the brain function of preterm infants with term asphyxia, and aEEG abnormality can be used as an early predictor of hypoxic-ischemic encephalopathy in term infants [2]. Recent studies have shown that abnormalities of aEEG are related to brain damage and poor neurological prognosis in preterm infant [3]. Our study was conducted on 60 preterm infants (26 - 36 w) in the first 7 days of life with exclusion of obvious congenital anomalies and hypoxic ischemic encephalopathy patients. Conclusion: This study confirms that aEEG background activity is strongly related to gestational age, birth weight, convulsions and IVH. AEEG combined with cranial ultrasound increases the sensitivity for detecting abnormal neurological outcome
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