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• W4387485698 abstract "Predicting neurodevelopmental outcome for neonates with hypoxic-ischemic encephalopathy (HIE) is important for clinical decision-making, care planning, and parent communication. We examined the relationship between EEG background and neurodevelopmental outcome among children enrolled in a trial of erythropoietin (Epo) or placebo for neonates with HIE treated with therapeutic hypothermia.Participants had EEG recorded throughout hypothermia. EEG background was classified as normal, discontinuous, or severely abnormal (defined as burst suppression, low voltage suppressed, or status epilepticus) at five one-hour epochs: onset of recording, 24, 36, 48, and 72 hours after birth. The predominant background pattern during the entire cEEG recording was calculated using the arithmetic mean of the five EEG background ratings (normal=0; discontinuous=1; severely abnormal=2) as follows: predominantly normal (mean=0), normal/discontinuous (0<mean<1), predominantly discontinuous (mean=1), discontinuous/severely abnormal (1<mean<2), or predominantly severely abnormal (mean=2). Primary outcome was death or neurodevelopmental impairment (NDI) defined as cerebral palsy, Gross Motor Function Classification Score ≥1 or cognitive score <90 on Bayley Scales of Infant Toddler Development, 3rd edition at age two years. Neurodevelopment was also categorized into a 5-level ordinal measure: no, mild, moderate, or severe NDI, or death for secondary analysis. We used generalized linear regression models with robust standard errors to assess the relative risk of death or NDI by EEG background in both unadjusted and adjusted analyses controlling for effects of treatment group, sex, HIE severity, and study recruitment site.Among 142 neonates, predominant background EEG pattern was predominantly normal in 35 (25%), normal/discontinuous in 68 (48%), predominantly discontinuous in 11 (7.7%), discontinuous/severely abnormal in 16 (11%), and predominantly severely abnormal in 12 (8.5%). Increasing severity of background across monitoring epochs was associated with increasingly worse clinical outcomes. Children with severe EEG background abnormality at any time point (n=36, 25%) were significantly more likely to die or have severe neurodevelopmental impairment at two years (adjusted relative risk: 7.95, 95% confidence interval 3.49-18.12).EEG background is strongly associated with NDI at age two years. These results can be used to assist health care providers to plan follow-up care and counsel families for decision making related to goals of care. NCT02811263." @default.
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• W4387485698 date "2023-10-10" @default.
• W4387485698 modified "2023-10-18" @default.
• W4387485698 title "Association of EEG Background and Neurodevelopmental Outcome in Neonates With Hypoxic-Ischemic Encephalopathy Receiving Hypothermia" @default.
• W4387485698 doi "https://doi.org/10.1212/wnl.0000000000207744" @default.
• W4387485698 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37816642" @default.
• W4387485698 hasPublicationYear "2023" @default.
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