Amplitude-integrated electroencephalography monitoring in newborns at high risk of seizure: Experience in a tertiary perinatal institute in Latin america
DOI:
https://doi.org/10.58597/rpe.v5i2.146Keywords:
Electroencephalography, Encephalopathy, Infant, Newborn, Physiologic Monitoring, Intensive Care, Neonatal, PediatricsAbstract
Objective: To describe the characteristics of amplitude-integrated electroencephalography (aEEG) monitoring and to assess the association between background patterns and clinical outcomes in newborns with encephalopathy or at high risk for seizures. Methods: A retrospective study was conducted at the National Maternal and Perinatal Institute in Lima, Peru. Newborns monitored with aEEG between 2024 and 2025 due to neonatal encephalopathy, suspected seizures, or clinical seizures were included. Background continuity patterns, sleep-wake cycling, electrographic seizures, and clinical outcomes were analyzed. Associations between categorical variables were assessed using chi-square or Fisher’s exact tests. Results: Sixty-five neonates were included (mean gestational age 35.4 ± 4.3 weeks; mean weight 2522 ± 1031 g). Overall mortality was 23.1% (15/65). A significant association was observed between the worst aEEG background pattern and neonatal mortality (χ² = 36.56, p < 0.001). Neonates with continuous, discontinuous, or low-voltage patterns showed 100% survival, whereas mortality increased among neonates with burst-suppression patterns (20–33%). The flat pattern was strongly associated with mortality, with 80% of these cases resulting in death (12/15). No significant association was found between sleep-wake cycles and the presence of electrographic seizures (p = 0.809). Conclusions: Amplitude-integrated EEG monitoring provides valuable information on cerebral function and prognosis in high-risk neonates. Severely abnormal background patterns, particularly flat activity, are strongly associated with neonatal mortality. These findings highlight the role of aEEG as a useful bedside neuromonitoring and prognostic tool in neonatal intensive care units, particularly in resource-limited settings.
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