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Arch Dis Child Fetal Neonatal Ed. 2016 May;101(3):F253-9. doi: 10.1136/archdischild-2015-308664. Epub 2015 Oct 30.

Neonatal EEG and neurodevelopmental outcome in preterm infants born before 32 weeks.

Author information

1
Department of Neonatal Medicine, University Hospital of Nantes, Nantes University, Nantes, France.
2
Department of Neonatal Medicine, University Hospital of Nantes, Nantes University, Nantes, France 'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France Clinical Research Center, INSERM CIC004, University Hospital of Nantes, Nantes, France.
3
'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France Department of Neonatal Medicine, Angers University, University Hospital of Angers, Angers, France.
4
Clinical Research Center, INSERM CIC004, University Hospital of Nantes, Nantes, France.
5
'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France.
6
'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France Clinical Research Center, INSERM CIC004, University Hospital of Nantes, Nantes, France.
7
'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France Department of Pediatric Neurology, Angers University, University Hospital of Angers, Angers, France.
8
'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France Department of Neonatal Medicine, Hospital of Le Mans, Le Mans, France.
9
Laboratoire d'Explorations Fonctionnelles, Nantes University, Centre de Référence Maladies Neuromusculaires Nantes-Angers, University Hospital of Nantes, Nantes, France.

Abstract

OBJECTIVE:

To assess the value of neonatal EEG for predicting non-optimal neurodevelopmental outcomes in very preterm infants, using a multimodal strategy of evaluation comprising brain imaging and clinical assessment.

DESIGN AND SETTING:

Between 2003 and 2009, we performed an observational, population-based study. Out of 2040 eligible preterm infants born before 32 weeks, 1954 were enrolled in the French regional Loire Infant Follow-Up Team (LIFT) cohort. 1744 (89%) of these completed the follow-up. Neonatal EEGs were recorded prospectively as two EEGs during the first 2 weeks of life and then one every 2 weeks up to 33 weeks.

MAIN OUTCOME MEASURES:

The neurodevelopmental outcome was assessed by physical examination, the Brunet-Lézine Test and/or the Age and Stages Questionnaire at 2 years of corrected age.

RESULTS:

Of the 1744 infants assessed at 2 years, 422 had a non-optimal outcome. A total of 4804 EEGs were performed, and 1345 infants had at least one EEG. EEG abnormalities were predictive of non-optimal outcomes after controlling for confounding factors such as severe intracranial lesions detected by brain imaging. Transient moderate and severe abnormalities were independent predictors of non-optimal outcomes with an OR and 95% CI of 1.49 (1.08 to 2.04) and 2.38 (1.49 to 3.81), respectively. In the validation group, the predictive risk stratification tree identified severe abnormalities as a factor contributing to the prognosis of two subgroups: infants with severe cranial lesions and infants with a normal examination at discharge and without severe cranial lesions.

KEYWORDS:

Clin Neurophysiology; Neonatology; Neurodevelopment

[Indexed for MEDLINE]

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