Relationship between EEG spectral power and dysglycemia with neurodevelopmental outcomes after neonatal encephalopathy

Objective We investigated how electroencephalography (EEG) quantitative measures and dysglycemia relate to neurodevelopmental outcomes following neonatal encephalopathy (NE). Methods This retrospective study included 90 neonates with encephalopathy who received therapeutic hypothermia. EEG absolute spectral power was calculated during post-rewarming and 2-month follow-up. Measures of dysglycemia (hypoglycemia, hyperglycemia, and glycemic lability) and glucose variability were computed for the first 48 hours of life. We evaluated the ability of EEG and glucose measures to predict neurodevelopmental outcomes at ≥18 months, using logistic regressions (with area under the receiver operating characteristic [AUROC] curves). Results The post-rewarming global delta power (average all electrodes), hyperglycemia and glycemic lability predicted moderate/severe neurodevelopmental outcome separately (AUROC=0.8, 95%CI [0.7,0.9], p<.001) and even more so when combined (AUROC=0.9, 95%CI [0.8,0.9], p<.001). After adjusting for NE severity and magnetic resonance imaging (MRI) brain injury, only global delta power remained significantly associated with moderate/severe neurodevelopmental outcome (odds ratio [OR]=0.9, 95%CI [0.8,1.0], p=.04), gross motor delay (OR=0.9, 95%CI [0.8,1.0], p=.04), global developmental delay (OR=0.9, 95%CI [0.8,1.0], p=.04), and auditory deficits (OR=0.9, 95%CI [0.8,1.0], p=.03). Conclusions In NE, global delta power post-rewarming was predictive of outcomes at ≥18 months. Significance EEG markers post-rewarming can aid prediction of neurodevelopmental outcomes following NE.