Effects of antenatal corticosteroid therapy in pregnant women on the brain development of preterm infants as assessed by amplitude-integrated electroencephalography

WU Di; JU Jun; CHANG He-Sheng

doi:10.7499/j.issn.1008-8830.2309148

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (3) : 244-249. DOI: 10.7499/j.issn.1008-8830.2309148

CLINICAL RESEARCH

Effects of antenatal corticosteroid therapy in pregnant women on the brain development of preterm infants as assessed by amplitude-integrated electroencephalography

WU Di, JU Jun, CHANG He-Sheng

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Abstract

Objective To investigate the effects of antenatal corticosteroid (ACS) therapy in pregnant women on the brain development of preterm infants using amplitude-integrated electroencephalography (aEEG). Methods A retrospective analysis was conducted on 211 preterm infants with a gestational age of 28 to 34⁺⁶weeks. The infants were divided into an ACS group (131 cases) and a control group (80 cases) based on whether antenatal dexamethasone was given for promoting fetal lung maturity. The first aEEG monitoring (referred to as aEEG1) was performed within 24 hours after birth, and the second aEEG monitoring (referred to as aEEG2) was performed between 5 to 7 days after birth. The aEEG results were compared between the two groups. Results In preterm infants with a gestational age of 28 to 31⁺⁶ weeks, the ACS group showed a more mature periodic pattern and higher lower amplitude boundary in aEEG1 compared to the control group (P<0.05). In preterm infants with a gestational age of 32 to 33⁺⁶ weeks and 34 to 34⁺⁶ weeks, the ACS group showed a higher proportion of continuous patterns, more mature periodic patterns and higher Burdjalov scores in aEEG1 (P<0.05). And the ACS group exhibited a higher proportion of continuous patterns, more mature periodic patterns, higher lower amplitude boundaries, narrower bandwidths, and higher Burdjalov scores in aEEG2 (P<0.05). Conclusions ACS-treated preterm infants have more mature aEEG patterns compared to those not treated with ACS, suggesting a beneficial effect of ACS on the brain development of preterm infants.

Key words

Brain development / Antenatal corticosteroid / Amplitude-integrated electroencephalography / Preterm infant

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WU Di, JU Jun, CHANG He-Sheng. Effects of antenatal corticosteroid therapy in pregnant women on the brain development of preterm infants as assessed by amplitude-integrated electroencephalography[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(3): 244-249 https://doi.org/10.7499/j.issn.1008-8830.2309148

References

1 Dagklis T, ?en C, Tsakiridis I, et al. The use of antenatal corticosteroids for fetal maturation: clinical practice guideline by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation[J]. Perinat J, 2022, 30(1): 1-11. DOI: 10.2399/prn.22.0301004.
2 俞秀雅, 程国强, 周文浩. 新生儿神经重症监护单元如何应用振幅整合脑电图[J]. 中国循证儿科杂志, 2015, 10(2): 119-125. DOI: 10.3969/j.issn.1673-5501.2015.02.008.
3 Shany E, Berger I, Goldberg O, et al. Do prenatal corticosteroids affect brain maturation of the premature infant? An electroencephalography study[J]. Clin EEG Neurosci, 2017, 48(2): 79-87. PMID: 27090506. DOI: 10.1177/1550059416643202.
4 Laptook AR, Chalak L, Pappas A, et al. The effects of betamethasone on the amplitude integrated EEG of infants born at 34- or 35-weeks gestation[J]. J Perinatol, 2022, 42(12): 1615-1621. PMID: 35618748. PMCID: PMC9699898. DOI: 10.1038/s41372-022-01415-4.
5 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 5版. 北京: 人民卫生出版社, 2019: 57-59.
6 中国抗癫痫协会脑电图与神经电生理分会新生儿脑电图学组. 新生儿振幅整合脑电图临床应用中国专家共识（2023）[J]. 中华新生儿科杂志（中英文）, 2023, 38(3): 129-135. DOI: 10.3760/cma.j.issn.2096-2932.2023.03.001.
7 Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates[J]. Pediatrics, 2003, 112(4): 855-861. PMID: 14523177. DOI: 10.1542/peds.112.4.855.
8 Richardson J, Goshen S, Meledin I, et al. Predictive value of early amplitude integrated EEG in extremely premature infants[J]. J Child Neurol, 2020, 35(11): 737-743. PMID: 32516024. PMCID: PMC7488832. DOI: 10.1177/0883073820930505.
9 Olischar M, Klebermass K, Kuhle S, et al. Reference values for amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks' gestational age[J]. Pediatrics, 2004, 113(1 Pt 1): e61-e66. PMID: 14702497. DOI: 10.1542/peds.113.1.e61.
10 慈春燕, 李文, 卢宪梅. 早产儿早期振幅整合脑电图特点的分析[J]. 山东大学学报（医学版）, 2012, 50(9): 109-112. DOI: 10.6040/j.issn.1671-7554.2012.09.024.
11 吴宏伟, 刘刚, 王伟, 等. 早产儿脑发育过程中振幅整合脑电图的变化[J]. 中华实用儿科临床杂志, 2017, 32(2): 109-111. DOI: 10.3760/cma.j.issn.2095-428X.2017.02.008.
12 Deshpande P, McNamara PJ, Hahn C, et al. A practical approach toward interpretation of amplitude integrated electroencephalography in preterm infants[J]. Eur J Pediatr, 2022, 181(6): 2187-2200. PMID: 35260920. DOI: 10.1007/s00431-022-04428-5.
13 Han Y, Fu N, Liang J, et al. Evaluation of maturity of sleep states in preterm infants using conventional and amplitude-integrated electroencephalography[J]. Sleep Med, 2020, 68: 154-159. PMID: 32044551. DOI: 10.1016/j.sleep.2019.09.016.
14 Vesoulis ZA, Paul RA, Mitchell TJ, et al. Normative amplitude-integrated EEG measures in preterm infants[J]. J Perinatol, 2015, 35(6): 428-433. PMID: 25521561. PMCID: PMC4447544. DOI: 10.1038/jp.2014.225.
15 Roberts D, Brown J, Medley N, et al. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth[J]. Cochrane Database Syst Rev, 2017, 3(3): CD004454. PMID: 28321847. PMCID: PMC6464568. DOI: 10.1002/14651858.CD004454.pub3.
16 Ancel PY, Goffinet F, EPIPAGE-2 Writing Group, et al. Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study[J]. JAMA Pediatr, 2015, 169(3): 230-238. PMID: 25621457. DOI: 10.1001/jamapediatrics.2014.3351.
17 Bustamante C, Valencia M, Torres C, et al. Effects of a single course of prenatal betamethasone on dendritic development in dentate gyrus granular neurons and on spatial memory in rat offspring[J]. Neuropediatrics, 2014, 45(6): 354-361. PMID: 25098832. DOI: 10.1055/s-0034-1387167.
18 Wu Y, Stoodley C, Brossard-Racine M, et al. Altered local cerebellar and brainstem development in preterm infants[J]. Neuroimage, 2020, 213: 116702. PMID: 32147366. PMCID: PMC7165064. DOI: 10.1016/j.neuroimage.2020.116702.
19 Pittet MP, Vasung L, Huppi PS, et al. Newborns and preterm infants at term equivalent age: a semi-quantitative assessment of cerebral maturity[J]. Neuroimage Clin, 2019, 24: 102014. PMID: 31683202. PMCID: PMC6838895. DOI: 10.1016/j.nicl.2019.102014.
20 Dimitrova R, Pietsch M, Ciarrusta J, et al. Preterm birth alters the development of cortical microstructure and morphology at term-equivalent age[J]. Neuroimage, 2021, 243: 118488. PMID: 34419595. PMCID: PMC8526870. DOI: 10.1016/j.neuroimage.2021.118488.