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PEDIATRICS Vol. 113 No. 1 January 2004, pp. e61-e66

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

Monika Olischar, MD^*, Katrin Klebermass, MD^*, Stefan Kuhle, MD^*, Margot Hulek, RT^*, Christina Kohlhauser, MD, PhD^*, Ernst Rücklinger, PhD, Arnold Pollak, MD, PhD^* and Manfred Weninger, MD, PhD^*

^* Division of Neonatology and Intensive Care, Department of Pediatrics, University of Vienna, Vienna, Austria
Rücklinger Statistical Consulting, Vienna, Austria

Objective. To prospectively investigate the development of amplitude-integrated electroencephalographic (aEEG) activity during the first 2 weeks of life in neurologically normal and clinically stable preterm infants <30 weeks’ gestational age (GA).

Patients and Methods. Infants with a GA of <30 weeks admitted to the neonatal intensive care unit of the Vienna University Children’s Hospital (Vienna, Austria) were studied prospectively by using aEEG and cranial ultrasound. Clinically stable infants without clinical or sonographic evidence of neurologic abnormalities were eligible for inclusion in the reference group. The distribution of 3 background aEEG activity patterns (discontinuous low-voltage, discontinuous high-voltage, and continuous), presence of sleep-wake cycles, and number of bursts per hour in the reference group were determined by visual analysis.

Results. Seventy-five infants (median GA: 27 weeks; range: 23–29 weeks) were eligible for inclusion in the reference group and had aEEG recordings during the first 2 weeks of life available. Analysis of aEEG background activity showed that with higher GA the relative amount of continuous activity increased while discontinuous patterns decreased. The number of bursts per hour decreased with increasing GA. Cyclical changes in aEEG background activity resembling early sleep-wake cycles were observed in all infants.

Conclusions. Normal values for aEEG background activity were determined in preterm infants <30 weeks’ GA. Clinically stable and neurologically normal preterm infants exhibit at least 2 different patterns of aEEG activity. There is a correlation between the GA and the relative duration of continuous aEEG activity.

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Key Words: amplitude-integrated EEG • aEEG • cerebral function monitor • preterm infant • reference values • sleep-wake cycles

Abbreviations: EEG, electroencephalography • aEEG, amplitude-integrated EEG • CFM, cerebral function monitor • IVH, intraventricular hemorrhage • GA, gestational age

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Received for publication May 21, 2003; Accepted Sep 15, 2003.

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