Neurodevelopmental forecasting in preterms: aEEG at 32 weeks vs. MRI at term in predicting 2-year outcomes

Objective: To evaluate the predictive accuracy of amplitude-integrated EEG (aEEG) at 32 weeks corrected age versus brain MRI at term-equivalent age in forecasting neurodevelopmental outcomes in very preterm infants. Study design: In this prospective cohort study, 71 infants born before 30 weeks' gestation underwent aEEG at 32 weeks and MRI at term-equivalent age. Neurodevelopmental outcomes were assessed using the Bayley-III at 12 and 24 months, and performance compared through LASSO regression models and ROC analysis. Results: Burdjalov aEEG and MRI scores were both significantly associated with Bayley-III outcomes. At 12 months, AUCs were 0.93 for aEEG and 0.96 for MRI. At 24 months, AUCs declined but MRI remained superior (0.92 vs. 0.78). The combined model showed the highest accuracy. Conclusion: aEEG at 32 weeks provides a valuable early indicator of neurodevelopmental outcomes, delivering clinically actionable information weeks before MRI and enabling timely interventions to support brain development in preterm infants.