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评估足月小于胎龄儿的新生儿脑电图背景和神经发育情况。

Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants.

机构信息

Department of Obstetrics and Gynecology, and Pediatrics, Universidad de La Laguna, La Laguna, Spain.

Department of Neonatology, Hospital Universitario de Canarias, La Laguna, Spain.

出版信息

Pediatr Res. 2020 Jul;88(1):91-99. doi: 10.1038/s41390-019-0693-0. Epub 2019 Dec 10.

Abstract

BACKGROUND

Delayed brain function development in small-gestational-age (SGA) infants has been reported. We aimed to quantify rates of immature neonatal EEG patterns and their association with neurodevelopment in SGA full-term neonates.

METHODS

Using a cohort design, 50 SGA (birthweight <10th percentile) and 44 appropriate-gestational-age (AGA) term neonates underwent continuous video-EEG recordings lasting >3 h. Seventy-three of them were assessed at 2-years-old using Bayley-III-Scales. For EEG analysis, several segments of discontinuous/alternating EEG tracings were selected.

MAIN OUTCOMES MEASURED

(1) Visual analysis (patterns of EEG maturity); (2) Power spectrum in δ, θ, α and β frequency bands; and (3) scores in motor, cognitive and language development.

RESULTS

(1) SGA infants, compared to AGA, showed: (a) higher percentages of discontinuous EEG, both asynchrony and interhemispheric asymmetry, and bursts with delta-brushes, longer interburst-interval duration and more transients/hour; (b) lower relative power spectrum in δ and higher in α; and (c) lower scores on motor, language and cognitive neurodevelopment. (2) Asymmetry >5%, interburst-interval >5 s, discontinuity >11%, and bursts with delta-brushes >11% were associated with lower scores on Bayley-III.

CONCLUSIONS

In this prospective study, SGA full-term neonates showed high rates of immature EEG patterns. Low-birthweight and immaturity EEG were both correlated with low development scores.

摘要

背景

小胎龄儿(SGA)的脑功能发育延迟已有报道。我们旨在量化不成熟新生儿脑电图模式的发生率及其与 SGA 足月新生儿神经发育的关系。

方法

采用队列设计,对 50 名 SGA(出生体重<第 10 百分位数)和 44 名适当胎龄(AGA)足月新生儿进行持续>3 小时的视频脑电图记录。其中 73 名在 2 岁时使用贝利 III 量表进行评估。对于脑电图分析,选择了几段不连续/交替的脑电图轨迹。

主要观察结果

(1)视觉分析(脑电图成熟模式);(2)δ、θ、α和β频带的功率谱;(3)运动、认知和语言发育评分。

结果

(1)与 AGA 相比,SGA 婴儿表现出:(a)更多的不连续脑电图,包括异步和半球间不对称,以及具有 delta 刷的爆发,更长的爆发间间隔持续时间和更多的瞬态/小时;(b)δ的相对功率谱较低,α的相对功率谱较高;(c)运动、语言和认知神经发育评分较低。(2)>5%的不对称、>5s 的爆发间间隔、>11%的不连续性和>11%的具有 delta 刷的爆发与贝利 III 评分较低相关。

结论

在这项前瞻性研究中,SGA 足月新生儿表现出高比例的不成熟脑电图模式。低出生体重和不成熟的脑电图均与发育评分较低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/219d/7326702/005b6ff8ae52/41390_2019_693_Fig1_HTML.jpg

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