Association between development of early cortical activity on amplitude-integrated EEG and 5-years neurodevelopmental outcome in the preterm infant

Aim To analyse the association between early aEEG and cognitive outcome at early school-age in very preterm infants. Methods Prospective cohort study including infants with gestational age (GA) <32.0 weeks, undergoing continuous aEEG recording during first 4 days of life. Semiquantitative and quantitative (maximum/minimum amplitude) measures were averaged over the recording period. Cognitive outcome was assessed with the Kaufman-Assessment Battery for Children at 5 years of age. Uni- and multivariate logistic regressions were calculated between aEEG parameters and normal cognitive outcome (IQ≥85). Results Among 118 monitored preterm children, 89 were assessed at median(IQR) corrected age of 68.6 months (65.5-71.2) [48% female, median(IQR) GA 29.9(28.2,30.9) weeks, mean(SD) birth weight 1235(363) grams]. Mean(SD) IQ was 97.8(12.7). IQ<85 occurred in 21.3 %, cerebral palsy was found in 3.4%. Despite univariate associations of total maturity scores, cycling subscores, background pattern and minimum aEEG amplitude with normal cognitive outcome none of the associations remained significant after adjustment for confounders. Socioeconomic status was identified as independent predictor of neurodevelopmental outcome. Conclusion In this cohort of very preterm infants, early short-term aEEG was not predictive of later cognitive outcome. Further research is needed to explore how aEEG could help to inform long-term prognosis in this population group. Key notes Preterm born infants are at high risk for neurodevelopmental impairment. Early amplitude integrated electroencephalography characteristics are univariately associated with cognitive outcome at 5 years of age in preterm born children. However, socioeconomic factors and neonatal morbidity were stronger predictors of long-term neurodevelopmental outcome than early aEEG measures.