Amplitude-integrated electroencephalography during the first 72 hours after birth in neonates diagnosed prenatally with congenital heart disease

BACKGROUND: Little is known on amplitude-integrated electroencephalography (aEEG) during the first days after birth in neonates with CHD. Our aim was, therefore, to assess electro-cortical activity using aEEG within the first 72 h after birth in neonates diagnosed prenatally with CHD, and to define independent prenatal and postnatal predictors for abnormal aEEG. METHODS: Neonates with CHD that were admitted to the neonatal intensive care unit between 2010 and 2017 were retrospectively included. We assessed aEEG background patterns, sleep-wake cycling, and epileptic activity during the first 72 h after birth and defined prenatal and postnatal clinical parameters associated with aEEG patterns. RESULTS: Seventy-two neonates were included. Twenty-six (36%) had mildly abnormal and six (8%) had severely abnormal aEEG background patterns at some point during the study period. Sleep-wake cycling was present in 97% of the neonates. Subclinical seizures were common (15%), while none of the neonates had clinical seizures. Only treatment with sedatives was a significant predictor for abnormal aEEG background patterns explaining 56% of the variance. CONCLUSION: Abnormal aEEG background patterns are common and strongly associated with treatment with sedatives in neonates with prenatally diagnosed CHD. Future studies should assess the association between early postnatal aEEG abnormalities and neurodevelopmental outcome.