Amplitude-integrated electroencephalography signals in preterm infants with cerebral hemorrhage

Objective: To evaluate whether preterm infants with cerebral hemorrhage show alterations of aEEG signals in the first four weeks of life. Study design: Preterm infants (n = 536) born before 32 completed weeks of pregnancy at Innsbruck Medical University Hospital were included in the study. AEEG recordings were evaluated for the Burdjalov score and cerebral hemorrhage was diagnosed by cerebral ultrasound. Results: Eighty preterm infants with cerebral hemorrhage (median gestational age 28.9 weeks, median birth weight 1157 g) and 456 preterm infants without cerebral hemorrhage (median gestational age 30.0 weeks, median birth weight 1300 g) were investigated. Burdjalov total scores were significantly lower in infants with cerebral hemorrhage. Infants with mild cerebral hemorrhage showed higher Burdjalov total scores compared to infants with severe cerebral hemorrhage in the first days of life. A Burdjalov total score of seven or more was predictive for no development of a cerebral hemorrhage, with a highest area under the curve (0.613) at postnatal day three. Conclusion: Preterm infants with cerebral hemorrhage show alterations in aEEG signals in the newborn period. In future aEEG could be used as a supplemental method to monitor preterm infants at risk for cerebral hemorrhage. The use of aEEG in early life could reduce the number of ultrasound examinations and limit cumulative stress and discomfort in preterm infants.

Automated summary

The study showed that preterm infants with cerebral hemorrhage have alterations in aEEG signals, with lower Burdjalo scores indicating the presence of cerebral hemorrhage. A Burdjalo total score of seven or more was predictive for no development of cerebral hemorrhage, with the highest area under the curve occurring on postnatal day three. The use of aEEG in early life could help monitor preterm infants at risk for cerebral hemorrhage and reduce the number of ultrasound examinations.