Perinatal factors associated with amplitude‐integrated electroencephalography abnormalities in preterm infants on the first day of life

Abstract

Objective

Evaluate the association between perinatal factors and amplitude‐integrated electroencephalogram abnormalities in preterm infants on the first day of life.

Methods

This was a cross‐sectional study of 60 infants with gestational age between 23 and 32 weeks, without malformations. Infants were continuously monitored by amplitude‐integrated electroencephalogram on the first day of life, for at least 3 h. The tracings were recorded and analyzed in each column for the following: burst‐suppression pattern, sleep‐wake cycle, and amplitude of the lower margin (<3 μV or <5 μV). The association of maternal complications, mode of delivery, birth weight, gestational age, neonatal sex, resuscitation procedures, hypothermia on admission, and the Score for Neonatal Acute Physiology, Perinatal Extension, Version II [SNAPPE‐II]) with amplitude‐integrated electroencephalogram alterations was assessed by multiple logistic regression.

Results

A discontinuous pattern occurred in 65% of infants, and a continuous pattern occurred in 23%. The burst‐suppression pattern was associated with vaginal delivery (OR: 7.6; 95% CI: 1.1–53.1) and SNAPPE‐II ≥ 40 (OR: 13.1; 95% CI: 1.8–95.1). A lower margin of the amplitude‐integrated electroencephalogram of <3 μV was also associated with SNAPPE‐II ≥ 40 (OR: 10.6, 95% CI: 2.3–49.2), while a value <5 μV was associated with lower GA (OR: 0.51, 95% CI: 0.34–0.76). There were no associations between the perinatal variables and the absence of a sleep‐wake cycle in amplitude‐integrated electroencephalogram recordings on the first day of life.

Conclusion

Biological variables and clinical severity are associated with electroencephalographic characteristics of preterm infants on the first day of life and should be considered in clinical practice when amplitude‐integrated electroencephalogram is performed.