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

•The activity of aEEG is negatively influenced by illness severity during the first 48 h after birth in extremely preterm infants.•After 48 h of birth the influence of illness severity disappears and a relationship of aEEG and MABP appears.•We don't know if low BP leads to poor neurodevelopmental outcome, however, aEEG was associated with neurodevelopmental outcome.

BackgroundThe management of hypotension immediately after the birth of preterm infants is controversial.AimTo investigate the relationship between blood pressure (BP), amplitude-integrated electroencephalography (aEEG), and neurodevelopmental outcome in extremely preterm infants.MethodsBP 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.ResultsMultiple 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.ConclusionThe 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.