Skip to main content
NCBI home page
Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1995 Jan;72(1):F34–F38. doi: 10.1136/fn.72.1.f34

Predictive value of early continuous amplitude integrated EEG recordings on outcome after severe birth asphyxia in full term infants.

L Hellström-Westas 1, I Rosén 1, N W Svenningsen 1
PMCID: PMC2528413  PMID: 7743282

Abstract

The background pattern in single channel amplitude integrated EEG recordings (aEEG) was recorded in 47 infants within the first six hours after birth to see if this could predict outcome after birth asphyxia. The aEEG background pattern during the first six hours of life was continuous and of normal voltage in 26 infants. All these infants survived; 25 were healthy, one had delayed psychomotor development. A continuous but extremely low voltage pattern was present in two infants, both of whom survived with severe handicap. Five infants had flat (mainly isoelectric) tracings during the first six hours of life; four died in the neonatal period, and one survived with severe neurological handicap. Burst-suppression pattern was identified in 14 infants, of whom five died, six survived with severe handicap, and three were healthy at follow up. The type of background pattern recorded within the first six postnatal hours in the aEEG tracings predicted outcome correctly in 43 of 47 (91.5%) infants. Use of aEEG monitoring can predict outcome, with a high degree of accuracy, after birth asphyxia, within the first six hours after birth. The predictive value of a suppression-burst pattern was, however, somewhat lower than the other background patterns. The aEEG seems to be a feasible technique for identifying infants at high risk of subsequent brain damage who might benefit from interventionist treatment after asphyxia.

Full text

PDF
F34

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Azzopardi D., Wyatt J. S., Cady E. B., Delpy D. T., Baudin J., Stewart A. L., Hope P. L., Hamilton P. A., Reynolds E. O. Prognosis of newborn infants with hypoxic-ischemic brain injury assessed by phosphorus magnetic resonance spectroscopy. Pediatr Res. 1989 May;25(5):445–451. doi: 10.1203/00006450-198905000-00004. [DOI] [PubMed] [Google Scholar]
  2. Bjerre I., Hellström-Westas L., Rosén I., Svenningsen N. Monitoring of cerebral function after severe asphyxia in infancy. Arch Dis Child. 1983 Dec;58(12):997–1002. doi: 10.1136/adc.58.12.997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Connell J., Oozeer R., de Vries L., Dubowitz L. M., Dubowitz V. Continuous EEG monitoring of neonatal seizures: diagnostic and prognostic considerations. Arch Dis Child. 1989 Apr;64(4 Spec No):452–458. doi: 10.1136/adc.64.4_spec_no.452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. De Vries L. S., Pierrat V., Eken P., Minami T., Daniels H., Casaer P. Prognostic value of early somatosensory evoked potentials for adverse outcome in full-term infants with birth asphyxia. Brain Dev. 1991 Sep;13(5):320–325. doi: 10.1016/s0387-7604(12)80126-4. [DOI] [PubMed] [Google Scholar]
  5. Eyre J. A., Oozeer R. C., Wilkinson A. R. Diagnosis of neonatal seizure by continuous recording and rapid analysis of the electroencephalogram. Arch Dis Child. 1983 Oct;58(10):785–790. doi: 10.1136/adc.58.10.785. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Finer N. N., Robertson C. M., Peters K. L., Coward J. H. Factors affecting outcome in hypoxic-ischemic encephalopathy in term infants. Am J Dis Child. 1983 Jan;137(1):21–25. doi: 10.1001/archpedi.1983.02140270017006. [DOI] [PubMed] [Google Scholar]
  7. Freeman J. M., Nelson K. B. Intrapartum asphyxia and cerebral palsy. Pediatrics. 1988 Aug;82(2):240–249. [PubMed] [Google Scholar]
  8. Hellström-Westas L. Comparison between tape-recorded and amplitude-integrated EEG monitoring in sick newborn infants. Acta Paediatr. 1992 Oct;81(10):812–819. doi: 10.1111/j.1651-2227.1992.tb12109.x. [DOI] [PubMed] [Google Scholar]
  9. Hellström-Westas L., Rosén I., Swenningsen N. W. Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring. Acta Paediatr Scand. 1985 Sep;74(5):741–748. doi: 10.1111/j.1651-2227.1985.tb10024.x. [DOI] [PubMed] [Google Scholar]
  10. Holmes G., Rowe J., Hafford J., Schmidt R., Testa M., Zimmerman A. Prognostic value of the electroencephalogram in neonatal asphyxia. Electroencephalogr Clin Neurophysiol. 1982 Jan;53(1):60–72. doi: 10.1016/0013-4694(82)90106-7. [DOI] [PubMed] [Google Scholar]
  11. Levene M. I., Fenton A. C., Evans D. H., Archer L. N., Shortland D. B., Gibson N. A. Severe birth asphyxia and abnormal cerebral blood-flow velocity. Dev Med Child Neurol. 1989 Aug;31(4):427–434. doi: 10.1111/j.1469-8749.1989.tb04020.x. [DOI] [PubMed] [Google Scholar]
  12. Levene M. I., Gibson N. A., Fenton A. C., Papathoma E., Barnett D. The use of a calcium-channel blocker, nicardipine, for severely asphyxiated newborn infants. Dev Med Child Neurol. 1990 Jul;32(7):567–574. doi: 10.1111/j.1469-8749.1990.tb08540.x. [DOI] [PubMed] [Google Scholar]
  13. Levene M. I. Management of the asphyxiated full term infant. Arch Dis Child. 1993 May;68(5 Spec No):612–616. doi: 10.1136/adc.68.5_spec_no.612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Levene M. I., Sands C., Grindulis H., Moore J. R. Comparison of two methods of predicting outcome in perinatal asphyxia. Lancet. 1986 Jan 11;1(8472):67–69. doi: 10.1016/s0140-6736(86)90718-x. [DOI] [PubMed] [Google Scholar]
  15. Monod N., Pajot N., Guidasci S. The neonatal EEG: statistical studies and prognostic value in full-term and pre-term babies. Electroencephalogr Clin Neurophysiol. 1972 May;32(5):529–544. doi: 10.1016/0013-4694(72)90063-6. [DOI] [PubMed] [Google Scholar]
  16. Nelson K. B., Ellenberg J. H. Apgar scores as predictors of chronic neurologic disability. Pediatrics. 1981 Jul;68(1):36–44. [PubMed] [Google Scholar]
  17. Pezzani C., Radvanyi-Bouvet M. F., Relier J. P., Monod N. Neonatal electroencephalography during the first twenty-four hours of life in full-term newborn infants. Neuropediatrics. 1986 Feb;17(1):11–18. doi: 10.1055/s-2008-1052492. [DOI] [PubMed] [Google Scholar]
  18. Robertson C., Finer N. Term infants with hypoxic-ischemic encephalopathy: outcome at 3.5 years. Dev Med Child Neurol. 1985 Aug;27(4):473–484. doi: 10.1111/j.1469-8749.1985.tb04571.x. [DOI] [PubMed] [Google Scholar]
  19. Sarnat H. B., Sarnat M. S. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976 Oct;33(10):696–705. doi: 10.1001/archneur.1976.00500100030012. [DOI] [PubMed] [Google Scholar]
  20. Thiringer K., Hrbek A., Karlsson K., Rosén K. G., Kjellmer I. Postasphyxial cerebral survival in newborn sheep after treatment with oxygen free radical scavengers and a calcium antagonist. Pediatr Res. 1987 Jul;22(1):62–66. doi: 10.1203/00006450-198707000-00015. [DOI] [PubMed] [Google Scholar]
  21. Thornberg E., Thiringer K. Normal pattern of the cerebral function monitor trace in term and preterm neonates. Acta Paediatr Scand. 1990 Jan;79(1):20–25. doi: 10.1111/j.1651-2227.1990.tb11324.x. [DOI] [PubMed] [Google Scholar]
  22. Vannucci R. C. Current and potentially new management strategies for perinatal hypoxic-ischemic encephalopathy. Pediatrics. 1990 Jun;85(6):961–968. [PubMed] [Google Scholar]
  23. Watanabe K., Miyazaki S., Hara K., Hakamada S. Behavioral state cycles, background EEGs and prognosis of newborns with perinatal hypoxia. Electroencephalogr Clin Neurophysiol. 1980 Sep;49(5-6):618–625. doi: 10.1016/0013-4694(80)90402-2. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group

RESOURCES