| Infants requiring neonatal intensive care admissions are at increased risk of adverse neurodevelopmental outcomes. Current methods of outcome prediction are inadequate. Conventional electroencephalograms (EEGs) can provide useful information, but are logistically difficult and require specialist interpretation.; Our hypothesis was that spectral edge frequency (SEF) and other quantitative parameters from two channel cotside EEGs can help predict long-term neurodevelopmental outcome.; We recruited 120 preterm infants born before 32 weeks gestation and performed between 2 and 10 cotside EEGs during their neonatal admission. We also recruited 24 term infants with, or at risk of, clinical seizures and recorded acute and convalescent cotside EEGs. EEGs were analysed offline to determine SEF, median and minimum amplitude, and continuity.; In normal preterm infants SEF fell over the first week, then slowly increased until 34-35 weeks corrected gestation. Median amplitude did not change, but minimum amplitude and continuity increased. This developmental pattern was delayed in the most immature infants. Low right ventricular output and diastolic blood pressure in the first 48 hours were associated with reduced EEG amplitude and continuity. Administration of surfactant and opiates were also associated with reduced continuity. EEG continuity but not SEF was weakly related to 18 month Bayley-II developmental indices.; In encephalopathic term infants, there was moderate agreement between the neurophysiologist's report on the conventional EEG and the background pattern of the amplitude-integrated EEG (aEEG), but not between assessments of sleep state cycling. The background aEEG pattern was the best EEG predictor of neurodevelopmental outcome. However, magnetic resonance imaging was a better predictor than either cotside or conventional EEG.; Our data suggest that the parameters measured from two channel cotside EEGs are not clinically useful for outcome prediction in preterm infants, but can assist in term infants. Cotside EEGs may also provide useful information regarding changes in neurophysiology after birth, cerebral responses to clinical interventions and postnatal cortical maturation in preterm infants. |
