Perinatal factors associated with amplitude-integrated electroencephalography abnormalities in preterm infants on the first day of life()()

OBJECTIVE: Evaluate the association between perinatal factors and amplitude-integrated electroencephalogram abnormalities in preterm infants on the first day of life. METHODS: This was a cross-sectional study of 60 infants with gestational age between 23 and 32 weeks, without malformations. Infants were continuously monitored by amplitude-integrated electroencephalogram on the first day of life, for at least 3 h. The tracings were recorded and analyzed in each column for the following: burst-suppression pattern, sleep-wake cycle, and amplitude of the lower margin (<3 μV or <5 μV). The association of maternal complications, mode of delivery, birth weight, gestational age, neonatal sex, resuscitation procedures, hypothermia on admission, and the Score for Neonatal Acute Physiology, Perinatal Extension, Version II [SNAPPE-II]) with amplitude-integrated electroencephalogram alterations was assessed by multiple logistic regression. RESULTS: A discontinuous pattern occurred in 65% of infants, and a continuous pattern occurred in 23%. The burst-suppression pattern was associated with vaginal delivery (OR: 7.6; 95% CI: 1.1–53.1) and SNAPPE-II ≥ 40 (OR: 13.1; 95% CI: 1.8–95.1). A lower margin of the amplitude-integrated electroencephalogram of <3 μV was also associated with SNAPPE-II ≥ 40 (OR: 10.6, 95% CI: 2.3–49.2), while a value <5 μV was associated with lower GA (OR: 0.51, 95% CI: 0.34–0.76). There were no associations between the perinatal variables and the absence of a sleep-wake cycle in amplitude-integrated electroencephalogram recordings on the first day of life. CONCLUSION: Biological variables and clinical severity are associated with electroencephalographic characteristics of preterm infants on the first day of life and should be considered in clinical practice when amplitude-integrated electroencephalogram is performed.