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Quantitative EEG in babies at risk for hypoxic ischemic encephalopathy after perinatal asphyxia

Journal of Perinatology volume 30, pages 122–126 (2010)Cite this article

Abstract

Objective:

To evaluate an electroencephalography (EEG)-based index, the Cerebral Health Index in babies (CHI/b), for identification of neonates with high Sarnat scores and abnormal EEG as markers of hypoxic ischemic encephalopathy (HIE) after perinatal asphyxia.

Study Design:

This is a retrospective study using 30 min of EEG data collected from 20 term neonates with HIE and 20 neurologically normal neonates. The HIE diagnosis was made on clinical grounds based on history and examination findings. The maximum-modified clinical Sarnat score was used to grade HIE severity within 72 h of life. All neonates underwent 2-channel bedside EEG monitoring. A trained electroencephalographer blinded to clinical data visually classified each EEG as normal, mild or severely abnormal. The CHI/b was trained using data from Channel 1 and tested on Channel 2.

Result:

The CHI/b distinguished among HIE and controls (P<0.02) and among the three visually interpreted EEG categories (P<0.0002). It showed a sensitivity of 82.4% and specificity of 100% in detecting high grades of neonatal encephalopathy (Sarnat 2 and 3), with an area under the receiver operator characteristic (ROC) curve of 0.912. CHI/b also identified differences between normal vs mildly abnormal (P<0.005), mild vs severely abnormal (P<0.01) and normal vs severe (P<0.002) EEG groups. An ROC curve analysis showed that the optimal ability of CHI/b to discriminate poor outcome was 89.7% (sensitivity: 87.5%; specificity: 82.4%).

Conclusion:

The CHI/b identified neonates with high Sarnat scores and abnormal EEG. These results support its potential as an objective indicator of neurological injury in infants with HIE.

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Acknowledgements

The project described was supported by Award Number R44HD042872 from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute Of Child Health & Human Development or the National Institutes of Health. BrainZ Instruments did not provide any financial support to this study.

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Authors and Affiliations

  1. Infinite Biomedical Technologies, Baltimore, MD, USA

    M Hathi, D L Sherman, N S Rothman, M Natarajan & A Natarajan

  2. Department of Pediatrics, Washington University in St Louis, St Louis, MO, USA

    T Inder

  3. Cedars—Sinai Medical Center, Los Angeles, CA, USA

    C Niesen

  4. Department of Obstetrics & Gynecology, University of Southern California, Los Angeles, CA, USA

    L M Korst

  5. BrainZ Instruments Ltd, Auckland, New Zealand

    T Pantano

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  1. M Hathi
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  2. D L Sherman
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  5. M Natarajan
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Correspondence to M Hathi.

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Hathi, M., Sherman, D., Inder, T. et al. Quantitative EEG in babies at risk for hypoxic ischemic encephalopathy after perinatal asphyxia. J Perinatol 30, 122–126 (2010). https://doi.org/10.1038/jp.2009.130

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