Temporal evolution of quantitative EEG within 3 days of birth in early preterm infants

John M O’Toole,Geraldine B Boylan,Nathan J Stevenson,Elena Pavlidis,Irina Korotchikova

doi:10.1038/s41598-019-41227-9

John M O’Toole, Geraldine B Boylan + Show 3 more

Open Access

https://doi.org/10.1038/s41598-019-41227-9

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Abstract

For the premature newborn, little is known about changes in brain activity during transition to extra-uterine life. We aim to quantify these changes in relation to the longer-term maturation of the developing brain. We analysed EEG for up to 72 hours after birth from 28 infants born <32 weeks of gestation. These infants had favourable neurodevelopment at 2 years of age and were without significant neurological compromise at time of EEG monitoring. Quantitative EEG was generated using features representing EEG power, discontinuity, spectral distribution, and inter-hemispheric connectivity. We found rapid changes in cortical activity over the 3 days distinct from slower changes associated with gestational age: for many features, evolution over 1 day after birth is equivalent to approximately 1 to 2.5 weeks of maturation. Considerable changes in the EEG immediately after birth implies that postnatal adaption significantly influences cerebral activity for early preterm infants. Postnatal age, in addition to gestational age, should be considered when analysing preterm EEG within the first few days after birth.

Highlights

For the newborn preterm infant, many physiological changes occur during the transition at birth from intra- to extra-uterine life
The small number of non-specific Quantitative EEG (qEEG) features used in these studies, without features of spatial and temporal organisation for example, are not comprehensive enough to capture the complexity of the preterm EEG
We aim to quantify the temporal evolution of qEEG over the first 3 days after birth for preterm infants

Summary

Introduction

For the newborn preterm infant, many physiological changes occur during the transition at birth from intra- to extra-uterine life. Quantitative EEG (qEEG) is used to develop fully automated methods of EEG analysis; qEEG measures are used in methods to estimate maturation[7,17] and classify sleep states[6,21], for example Such systems can integrate cotside and provide continuous information on cerebral function to the non-expert. We hypothesize that the biological and environmental factors associated with preterm birth will alter the typical intra-uterine maturation of the EEG to produce rapid changes in the EEG. To test this hypothesis, we aim to quantify the temporal evolution of qEEG over the first 3 days after birth for preterm infants

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