Sleep wake cycling and neurodevelopmental outcome in very low birth weight infants

Abstract

Background: Although the maturation of sleep wake cycling (SWC) in premature infants has been described, its value in predicting neurodevelopmental outcome (NDO) is yet to be known.Objective: To examine the relationship between NDO and SWC evaluated by amplitude integrated electroencephalogram (aEEG) in very low birth weight (VLBW) infants.Study design: VLBW infants (<1500 grams and ≤34 weeks gestational age) were enrolled in a prospective study. Two channel 12-hour aEEG recordings were completed at 34 weeks postmenstrual age (PMA) and SWC scores were assigned. NDO was measured by the Bayley’s Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) at 9 and 18 months corrected age (CA).Results: Eighty-four of the 103 enrolled infants had an aEEG completed at 34 weeks PMA. At 9 months CA, in linear regression models, MDI was significantly associated with severe intraventricular hemorrhage (IVH) and SWC score, while PDI was associated with GA and SWC score. At 18 months CA, these associations lost significance.Conclusions: At 34 weeks PMA, all VLBW premature infants demonstrate some degree of SWC on aEEG. Maturation of SWC at 34 weeks PMA is not associated with gestational age, however may relate to early NDO. Further studies are needed to evaluate this relationship.