Prognostic Accuracy of Electroencephalograms in Preterm Infants: A Systematic Review.

Abstract

Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant. To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants for predicting neurodevelopmental outcome. The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported neurodevelopmental outcomes 1 to 10 years later. Two reviewers independently performed data extraction with regard to participants, prognostic testing, and outcomes. Thirteen observational studies with a total of 1181 infants were included. A meta-analysis was performed based on 3 studies (267 infants). Any aEEG background abnormality was a predictor of abnormal outcome. For prediction of a developmental quotient <70 points, cerebral palsy, or death, the pooled sensitivity was 0.83 (95% confidence interval, 0.69-0.92) and specificity 0.83 (95% confidence interval, 0.77-0.87). All studies were at high risk of bias. Heterogeneity was evident among the studies with regard to the investigated aEEG and EEG variables, neurodevelopmental outcomes, and cutoff values. aEEG or EEG recorded within the first 7 days of life in preterm infants may have potential as a predictor for later neurodevelopmental outcome. We need high-quality studies to confirm these findings. Meanwhile, the prognostic value of aEEG and EEG should be used only as a scientific tool.