Electroencephalographic studies in growth-restricted and small-for-gestational-age neonates

Foetal growth restriction (FGR) and being born small for gestational age (SGA) are associated with neurodevelopmental delay. Early diagnosis of neurological damage is difficult in FGR and SGA neonates. Electroencephalography (EEG) has the potential as a tool for the assessment of brain development in FGR/SGA neonates. In this review, we analyse the evidence base on the use of EEG for the assessment of neonates with FGR or SGA. We found consistent findings that FGR/SGA is associated with measurable changes in the EEG that present immediately after birth and persist into childhood. Early manifestations of FGR/SGA in the EEG include changes in spectral power, symmetry/synchrony, sleep-wake cycling, and the continuity of EEG amplitude. Later manifestations of FGR/SGA into infancy and early childhood include changes in spectral power, sleep architecture, and EEG amplitude. FGR/SGA infants had poorer neurodevelopmental outcomes than appropriate for gestational age controls. The EEG has the potential to identify FGR/SGA infants and assess the functional correlates of neurological damage. Impact FGR/SGA neonates have significantly different EEG activity compared to AGA neonates. EEG differences persist into childhood and are associated with adverse neurodevelopmental outcomes. EEG has the potential for early identification of brain impairment in FGR/SGA neonates.

Automated summary

This review explores the potential of electroencephalography (EEG) as a tool for assessing brain development in fetuses with growth restriction (FGR) or born small for gestational age (SGA). Findings suggest that FGR/SGA is associated with measurable changes in EEG immediately after birth and into childhood. Early manifestations in EEG include changes in spectral power, symmetry/synchrony, sleep-wake cycling, and continuity of EEG amplitude, while later manifestations include changes in spectral power, sleep architecture, and EEG amplitude. FGR/SGA infants also show poorer neurodevelopmental outcomes compared to those appropriate for gestational age (AGA). EEG has the potential to identify FGR/SGA infants and assess the functional correlates of neurological damage.