Background and objective Survival in infants with congenital heart defects (CHD) is associated with neurologic morbidity. Hypoxic-ischemia after closure of the ductus arteriosus is probably one of the factors resulting in brain damage. Prenatal diagnosis makes it possible to prevent closure of the ductus arteriosus and therefore cerebral perfusion can be preserved. Amplitude integrated EEG (aEEG) is a method to evaluate brain injury. Abnormal (a)EEG patterns and epileptic activity (EA) are frequently observed in infants with CHD. Our aim was to determine the course of aEEG patterns in infants with prenatally diagnosed CHD.
Methods Retrospective cohort study of infants prenatally diagnosed with CHD. aEEGs were assessed by pattern recognition: background pattern (BP), presence of sleep wake cycling (SWC) and EA were appraised.
Results Twenty infants (mean GA 39 wks; birth weight 3416 g) were included. Eleven infants had transposition of the great arteries, 7 infants had hypoplastic left heart syndrome, and 2 had aortic valve stenosis. At 6h after birth 80% of infants had normal BPs (continuous normal voltage (CNV)). Only 2 infants had severely abnormal BPs (continuous low voltage). At 24h, 94% had CNV. None of the infants showed EA. SWC was present in 85% and emerged at a median postnatal age of 10.4 hrs.
Conclusions aEEGs of infants with a prenatally diagnosed CHD are normal in the majority of infants, with normal emergence of SWC and absence of EA. This indicates that prenatal diagnosis can prevent brain damage in infants with CHD.