Kong Annice H T, Lai Melissa M, Finnigan Simon, Ware Robert S, Boyd Roslyn N, Colditz Paul B
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia; The University of Queensland, Perinatal Research Centre, Faculty of Medicine, Brisbane, Australia.
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia; The University of Queensland, Perinatal Research Centre, Faculty of Medicine, Brisbane, Australia.
Early Hum Dev. 2018 Dec;127:74-84. doi: 10.1016/j.earlhumdev.2018.09.015. Epub 2018 Oct 16.
Very preterm infants are at risk of cognitive impairment, but current capacity to predict at-risk infants is sub-optimal. Electroencephalography (EEG) has been used to assess brain function in development. This review investigates the relationship between EEG and cognitive outcomes in very preterm infants.
Two reviewers independently conducted a literature search in April 2018 using PubMed, CINAHL, PsycINFO, Cochrane Library, Embase and Web of Science. Studies included very preterm infants (born ≤34 weeks gestational age, GA) who were assessed with EEG at ≤43 weeks postmenstrual age (PMA) and had cognitive outcomes assessed ≥3 months of age. Data on the subjects, EEG, cognitive assessment, and main findings were extracted. Meta-analysis was undertaken to calculate pooled sensitivity and specificity.
31 studies (n = 4712 very preterm infants) met the inclusion criteria. The age of EEG, length of EEG recording, EEG features analysed, age at follow-up, and follow-up assessments were diverse. The included studies were then divided into categories based on their analysed EEG feature(s) for meta-analysis. Only one category had an adequate number of studies for meta-analysis: four papers (n = 255 very preterm infants) reporting dysmature/disorganised EEG patterns were meta-analysed and the pooled sensitivity and specificity for predicting cognitive outcomes were 0.63 (95% CI: 0.53-0.72) and 0.83 (95% CI: 0.74-0.89) respectively.
There is preliminary evidence that background EEG features can predict cognitive outcomes in very preterm infants. Reported findings were however too heterogeneous to determine which EEG features are best at predicting cognitive outcome.
极早产儿有认知障碍风险，但目前预测高危婴儿的能力欠佳。脑电图（EEG）已用于评估发育中的脑功能。本综述研究极早产儿EEG与认知结局之间的关系。
两名综述作者于2018年4月独立使用PubMed、CINAHL、PsycINFO、Cochrane图书馆、Embase和科学网进行文献检索。研究纳入在月经龄（PMA）≤43周时接受EEG评估且在≥3月龄时进行认知结局评估的极早产儿（出生时胎龄≤34周，GA）。提取关于受试者、EEG、认知评估和主要发现的数据。进行荟萃分析以计算合并敏感性和特异性。
31项研究（n = 4712名极早产儿）符合纳入标准。EEG检查年龄、EEG记录时长、分析的EEG特征、随访年龄和随访评估各不相同。然后根据分析的EEG特征将纳入研究分为几类进行荟萃分析。只有一类有足够数量的研究可进行荟萃分析：对4篇报告EEG模式不成熟/紊乱的论文（n = 255名极早产儿）进行荟萃分析，预测认知结局的合并敏感性和特异性分别为0.63（95%CI：0.53 - 0.72）和0.83（95%CI：0.74 - 0.89）。
有初步证据表明背景EEG特征可预测极早产儿的认知结局。然而，报告的研究结果差异太大，无法确定哪些EEG特征最能预测认知结局。
