Peer-Reviewed Journal Details
Mandatory Fields
Garvey, Aisling A.; Pavel, Andreea; O'Toole, John M.; Walsh, Brian; Korotchikova, Irina; Livingstone, Vicki; Dempsey, Eugene M.; Murray, Deirdre M.; Boylan, Geraldine B.
2021
July
Pediatric Research
Multichannel EEG abnormalities during the first 6 hours in infants with mild hypoxic-ischaemic encephalopathy
Validated
WOS: 1 ()
Optional Fields
Amplitude-integrated EEG Heart-rate-variability Short-term outcomes Full-term Systemic hypothermia Therapeutic hypothermia Neonatal encephalopathy Predictive-value Newborns Electroencephalography
90
1
117
124
Background Infants with mild HIE are at risk of significant disability at follow-up. In the pre-therapeutic hypothermia (TH) era, electroencephalography (EEG) within 6 hours of birth was most predictive of outcome. This study aims to identify and describe features of early EEG and heart rate variability (HRV) (<6 hours of age) in infants with mild HIE compared to healthy term infants. Methods Infants >36 weeks with mild HIE, not undergoing TH, with EEG before 6 hours of age were identified from 4 prospective cohort studies conducted in the Cork University Maternity Services, Ireland (2003-2019). Control infants were taken from a contemporaneous study examining brain activity in healthy term infants. EEGs were qualitatively analysed by two neonatal neurophysiologists and quantitatively assessed using multiple features of amplitude, spectral shape and inter-hemispheric connectivity. Quantitative features of HRV were assessed in both the groups. Results Fifty-eight infants with mild HIE and sixteen healthy term infants were included. Seventy-two percent of infants with mild HIE had at least one abnormal EEG feature on qualitative analysis and quantitative EEG analysis revealed significant differences in spectral features between the two groups. HRV analysis did not differentiate between the groups. Conclusions Qualitative and quantitative analysis of the EEG before 6 hours of age identified abnormal EEG features in mild HIE, which could aid in the objective identification of cases for future TH trials in mild HIE. ImpactInfants with mild HIE currently do not meet selection criteria for TH yet may be at risk of significant disability at follow-up. In the pre-TH era, EEG within 6 hours of birth was most predictive of outcome; however, TH has delayed this predictive value. 72% of infants with mild HIE had at least one abnormal EEG feature in the first 6 hours on qualitative assessment. Quantitative EEG analysis revealed significant differences in spectral features between infants with mild HIE and healthy term infants. Quantitative EEG features may aid in the objective identification of cases for future TH trials in mild HIE.
LONDON
0031-3998
10.1038/s41390-021-01412-x
Grant Details