PROGNOSTIC VALUE OF NEONATAL ELECTROENCEPHALOGRAPHY IN PREMATURE NEWBORNS LESS-THAN 33 WEEKS OF GESTATIONAL-AGE

In a prospective study of 417 premature neonates born before 33 weeks' gestational age, neonatal tracings were reviewed to evaluate the use of EEG in prognosis of neurological injuries. The population was divid ed into two groups: Group 1, infants who died before the age of 1, and Group 2, survivors in which two categories of motor development were considered. Category A, were abnormal, and Category B, were always nor mal. Positive rolandic sharp waves (PRSW), which reflect white matter injury, occurred equally in both groups, indicating a similar incidenc e of white matter damage in Groups 1 and 2. In Group 2, there was a si gnificant correlation of PRSW with developmental motor sequelae (Categ ory A). A frequency of PRSW above 2/min (suggesting more severe perive ntricular white matter injury) and seizures were significantly more pr evalent in Group 1 than in Group 2 and in Category A of Group 2 than i n Category B. Background abnormalities occurred equally in both subgro ups of extremely premature infants (less than or equal to 28 weeks' ge station) they were significantly more numerous in the subgroup of very premature infants (between 28 and 33 weeks' gestation) who died, than in the subgroup of very premature infants who survived. This study sh ows the potential utility of using neonatal EEG in association with tr ansfontanellar ultrasonography in anticipating the neurological develo pment of very (>28 weeks' gestation) and extremely (less than or equal to 28 weeks' gestation) premature newborns. (C) 1997 Elsevier Science Ireland Ltd.