A study on clinical correlation of EEG in neonates with perinatal asphyxia

Rajendra Shinde, Kiran Haridas, Madhavi Shelke, L. S. Deshmukh, P. S. Patil


Background: Perinatal asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. The WHO has estimated that 4 million babies die during the neonatal period every year. According to WHO, perinatal asphyxia is defined as the failure to initiate and sustain breathing at birth. The objective is to study the electroencephalographic changes and correlation between severity of Perinatal asphyxia with EEG changes.

Methods: It is prospective observational study, which includes 40 term neonates admitted in NICU with perinatal asphyxia in GMCH Aurangabad. EEG analysis focused on background activity and classified into four categories.

Results: The EEG was normal in 45%, mild abnormal in 25%, intermediate in 15%, and severely abnormal in 15%.  Outcome at discharge was normal in 19(47.5%) and abnormal in 21(52.5%) including 1 death. Abnormal outcome was seen in 27% of newborns with normal EEG and 72% of abnormal EEG.

Conclusions: Severity of perinatal asphyxia correlated well with abnormality of EEG. EEG changes and severity showed good correlation with immediate outcome of newborn in terms of duration of hospitalization and normal neurological examination.


EEG, Neonates, Outcome, Perinatal asphyxia

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Mizrahi EM, Hrachovy RA, Kellaway P. Techniques of recording the neonatal electroencephalogram in atlas of neonatal encephalography. 3rd ed. Philadelphia USA: Lippincott Williams and Wilkins; 2004.

Dongol S, Singh J, Shrestha S, Shakya A. clinical profile of birth asphyxia in Dhulikhel hospital: a retrospective study. J Nep Paedtr Soc. 2010;30(3):141-6.

Stanley FJ, Blair E. Why have we failed to reduce the frequency of cerebral palsy? Med J Aust. 1991;154(9):623-6.

Agarwal R, Jain A, Deorari A, Paul V. Post-resuscitation management of asphyxiated neonate’s Indian J Pediatr. 2008;75(2):175-80.

Mc Intosh N. Stenson B. The newborn in Forfar textbook of pediatrics. 5th ed. New Delhi: Elsevier, a division of Reed Elsevier India private limited; 2008:191-366.

World Health organization. Basic Newborn Resuscitation; A Practical Guide. World Health Organization: Geneva 1997. Available at: health/ publication/MSM 98 /introduction en.html

Levene M, Evans D. Hypoxic-ischemic brain injury in Robertons Textbook of Neonatology. 4th ed. Elsevier publication; 2005:1128-1148.

Takeuchi T, Watanabe K. The EEG evolution and neurological prognosis of neonates with perinatal hypoxia . Brain Dev. 1989;11(2):115-20.

Ong LC, Kanaheswari Y, Chandran V, Rohana J, Yong SC, Boo NY. The usefulness of early ultrasonography, electroencephalography and clinical parameters in predicting adverse outcomes in asphyxiated term infants. Singapore Med J. 2009;50(7):705-9.

Park K. Preventive medicine in obstetrics, paediatrics and geriatrics in parks textbook of preventive and social medicine. 21st ed. Jabalpur: Banarasidas Bhanot Publishers; 2011:481-560.

El-Ayouty M, Abdel-Hady H, El-Mogy S, Zaghlol H, El-Beltagy M, Aly H. Prognosis of term infants with hypoxic ischemic encephalopathy a clinical EEG and MRI study. Int J Ch Neuropsychiatry. 2005;2(1):15-21.

Leijser LM, Vein AA, Liauw L, Strauss T, Veen S, Wezel-Meijler G. Prediction of short-term neurological outcome in full-term neonates with - hypoxic-schaemicencephalopathy based on combined use of electroence-phalogram and neuro-imaging. Neuropediatr. 2007;38(5):219-27.

Nagy E, Orvos H, Bakki J, Pal A. Sex-differences in Apgar scores for full-term neonates Acta Paediatr. 2009;98(5):898-900.

Doménech Martínez E, Castro Conde JR, Lorenzo CR, Méndez Pérez A, González-Azpeitia G. Prognostic value of the electroencephalogram in hypoxic ischemic encephalopathy. An Esp Pediatr. 1993;38(6):517-23.

Allemand F, Reale F, Sposato M, Allemand A. Perinatal hypoxic-ischemic encephalopathy: epileptic and paretic outcome at one year of age. Ital J Pediatr. 2009;35(1):14.

Haidary M, Hussain A, Ahmed S, Kasem A. Clinical profile of birth asphyxia in Rajshahi Medical College Hospital. J Teachers Assoc Bangladesh. 2005;18(2):106-8.