Blood pressure and aEEG in the 96 h after birth and correlations with neurodevelopmental outcome in extremely preterm infants

Background: The management of hypotension immediately after the birth of preterm infants is controversial. Aim: To investigate the relationship between blood pressure (BP), amplitude-integrated electroencephalography (aEEG), and neurodevelopmental outcome in extremely preterm infants. Methods: BP and aEEG were monitored for 96 h after birth in 36 infants born at <27 weeks gestation. aEEG data were analyzed with Burdjalov scores. Correlations of aEEG findings with BP and several clinical characteristics, including the Score for Neonatal Acute Physiology, Perinatal Extension-II (SNAPPE-II) were explored. A subgroup analysis of BP, aEEG activity, and neurodevelopmental outcome at 18-22 months corrected age was also performed. Poor outcome was defined as death or a developmental quotient <70. Results: Multiple regression analyses revealed no association between BP during the first 48 h after birth and aEEG activity. However, BP 48-96 h after birth was significantly associated with simultaneous aEEG activity (p < 0.001). Within 48 h after birth, SNAPPE-II was significantly associated with aEEG activity. Outcome was assessed in 32 infants; 24 and 8 of whom had good and poor outcomes, respectively. aEEG activity was significantly lower in neonates with a poor outcome than those with a good outcome (<0.001). No significant differences in outcome were observed for BP. Conclusion: The activity of aEEG was associated with illness severity during the first 48 h after birth. After 48 h, there was no effect of illness severity but there was an association with BP. We do not know if hypotension results in a poor outcome. However, aEEG activity was associated with neurodevelopmental outcome. (c) 2016 Elsevier Ireland Ltd. All rights reserved.