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The effects of betamethasone on the amplitude integrated EEG of infants born at 34- or 35-weeks gestation

Journal of Perinatology volume 42, pages 1615–1621 (2022)Cite this article

Subjects

Abstract

Objective

Assess if maternal betamethasone administration at 34–35 weeks accelerated neonatal amplitude integrated EEG (aEEG) maturation.

Study design

Nested, observational cohort in 7 centers participating in the Antenatal Late Preterm Steroid randomized trial. Up to 2 aEEGs were obtained in neonates born from 340–356 weeks gestation before 72 h (aEEG 1) and at 5–7 days (aEEG 2) if hospitalized. Personnel and aEEG central readers were masked to the intervention. The primary outcome was maturation reflected by cycle frequency; secondary outcomes were border voltage, span, and discontinuity.

Results

58 neonates were enrolled (betamethasone, 28, placebo, 30). On aEEG 1, cycle frequency did not differ, but betamethasone exposed infants had a greater lower border voltage and a broader span. On aEEG 2, both groups displayed increases in lower border voltage.

Conclusions

Betamethasone associated changes in lower border voltage support accelerated electrical activity. Further investigation is needed to understand the broader span.

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Fig. 1: The recording illustrates characteristics of an amplitude integrated EEG (aEEG).

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Data availability

Data reported in this paper may be requested through a data use agreement. Further details are available at https://neonatal.rti.org/index.cfm?fuseaction=DataRequest.Home.

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Acknowledgements

The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Heart, Lung, and Blood Institute, and the National Center for Advancing Translational Sciences provided grant support for the Maternal-Fetal Medicine Units Network’s ALPS trial and the Neonatal Research Network’s aEEG secondary study. NICHD staff provided input into the study design, conduct, analysis, and manuscript drafting; NCATS cooperative agreements provided infrastructure support to the NRN. While NICHD staff had input into the study design, conduct, analysis, and manuscript drafting, the comments and views of the authors do not necessarily represent the views of NICHD, the National Institutes of Health, the Department of Health and Human Services, or the U.S. Government. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data included in this study. On behalf of the NRN, RTI International had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. The investigators below, in addition to those listed as authors, participated in this study.

Funding

Financial support was provided by NICHD Cooperative Multicenter Neonatal Research Network, UG1HD027904 and the NICHD Cooperative Multicenter Maternal-Fetal Medicine Units Network, U10HD036801. ClinicalTrials.gov ID ALPS: NCT01222247.

Author information

Author notes

  1. Deceased: Elizabeth A. Thom.

Authors and Affiliations

  1. Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA

    Abbot R. Laptook, William Oh & Angelita M. Hensman

  2. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Lina Chalak

  3. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    Athina Pappas & Seetha Shankaran

  4. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA, USA

    Alexis Davis & Krisa P. Van Meurs

  5. Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State College of Medicine, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Pablo J. Sanchez

  6. Neonatology, Wellington Medical Center, Boca Raton, FL, USA

    Ross Sommers

  7. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Women and Infants Hospital, Brown University, Providence, RI, USA

    Dwight J. Rouse

  8. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle, NC, USA

    Scott McDonald

  9. Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA

    Abhik Das

  10. Department of Pediatrics, Duke University, Durham, NC, USA

    Ronald N. Goldberg

  11. Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA

    Namasivayam Ambalavanan

  12. Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA

    Cynthia Gyamfi-Bannerman

  13. Department of Biostatistics and Bioinformatics, George Washington University, Washington, DC, USA

    Elizabeth A. Thom

  14. Department of Global and Community Health, George Mason University, Fairfax, VA, USA

    Rosemary D. Higgins

  15. Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA

    Abbot R. Laptook, William Oh & Angelita M. Hensman

  16. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Lina Chalak

  17. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    Athina Pappas & Seetha Shankaran

  18. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA, USA

    Alexis Davis & Krisa P. Van Meurs

  19. Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State College of Medicine, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Pablo J. Sanchez

  20. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle, NC, USA

    Scott McDonald

  21. Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA

    Abhik Das

  22. Department of Pediatrics, Duke University, Durham, NC, USA

    Ronald N. Goldberg

  23. Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA

    Namasivayam Ambalavanan

  24. Department of Global and Community Health, George Mason University, Fairfax, VA, USA

    Rosemary D. Higgins

  25. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Women and Infants Hospital, Brown University, Providence, RI, USA

    Dwight J. Rouse

  26. Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA

    Cynthia Gyamfi-Bannerman

  27. Department of Biostatistics and Bioinformatics, George Washington University, Washington, DC, USA

    Elizabeth A. Thom

Authors
  1. Abbot R. Laptook
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Consortia

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN)

  • Abbot R. Laptook
  • , Lina Chalak
  • , Athina Pappas
  • , Alexis Davis
  • , Pablo J. Sanchez
  • , Krisa P. Van Meurs
  • , William Oh
  • , Seetha Shankaran
  • , Angelita M. Hensman
  • , Scott McDonald
  • , Abhik Das
  • , Ronald N. Goldberg
  • , Namasivayam Ambalavanan
  •  & Rosemary D. Higgins

Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network

  • Dwight J. Rouse
  • , Cynthia Gyamfi-Bannerman
  •  & Elizabeth A. Thom

Contributions

ARL, MD made substantial contributions to the conception of the work, acquisition and interpretation of the data, drafting the manuscript, approved the submitted version and is personally accountable for the manuscript. LC, MD made substantial contributions to the conception of the work, acquisition and interpretation of the data, drafting the manuscript, approved the submitted version and is personally accountable for the manuscript. AP, MD made substantial contributions to the conception of the work, acquisition and interpretation of the data, drafting the manuscript, approved the submitted version and is personally accountable for the manuscript. AD, MD made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. PJS, MD made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. KPVM made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. WO, MD made substantial contributions to the conception of the work, interpretation of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. RS, MD made substantial contributions to the conception of the work, interpretation of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. SS, MD made substantial contributions to the conception of the work, interpretation of the data, review of the manuscript, approved the submitted version and is personally accountable for the manuscript. AMH, PhD, RNC-NIC made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. DJR, MD made substantial contributions to the conception of the work, interpretation of the data, review of the manuscript, approved the submitted version and is personally accountable for the manuscript. SM, BS made substantial contributions to the conception of the work, interpretation of the data, analysis of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. AD, PhD made substantial contributions to the conception of the work, interpretation of the data, analysis of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. RNG, MD made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. NA, MD made contribution to the acquisition of the data, editing the manuscript, approved the submitted version and is personally accountable for the manuscript. CGB, MD made substantial contributions to the conception of the work, interpretation of the data, review of the manuscript, approved the submitted version and is personally accountable for the manuscript. EAT, MD made substantial contributions to the conception of the work, interpretation of the data, review of the manuscript, approved the submitted version and is personally accountable for the manuscript. RDH, MD made substantial contributions to the conception of the work, interpretation of the data, review of the manuscript, approved the submitted version and is personally accountable for the manuscript.

Corresponding author

Correspondence to Abbot R. Laptook.

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Laptook, A.R., 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 Perinatol 42, 1615–1621 (2022). https://doi.org/10.1038/s41372-022-01415-4

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