Maximilien Périvier1, Jean-Christophe Rozé2, Géraldine Gascoin3, Matthieu Hanf4, Bernard Branger5, Valérie Rouger6, Isabelle Berlie7, Yannis Montcho8, Yann Péréon9, Cyril Flamant2, Sylvie Nguyen The Tich7. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Sujith S Pereira; Stephen T Kempley; David F Wertheim; Ajay K Sinha; Joan K Morris; Divyen K Shah Journal: Front Neurol Date: 2018-02-26 Impact factor: 4.003