Background: Intraventricular hemorrhage (IVH) is a common and significant complication in premature infants. While cranial ultrasound is the golden standard for IVH detection, it may not identify lesions until hours or days after occurring, which limits early intervention. Predicting IVH in premature infants would be highly advantageous. Recent studies have shown that EEG data's amplitude and frequency modulation features could offer predictive insights for neurological diseases in adults. Methods: To investigate the association between IVH and EEG monitoring, a retrospective case-control study was conducted in preterm infants. All infants underwent amplitude integrated EEG monitoring for at least 3 days after birth. The study included 20 cases who had an IVH diagnosed on cranial ultrasound and had a negative ultrasound 24h earlier, and 20 matched controls without IVH. Amplitude and frequency modulation features were extracted from single-channel EEG data, and various machine learning algorithms were evaluated to create a predictive model. Results: Cases had an average gestational age and birth weight of 26.4 weeks and 965 grams, respectively. The best-performing algorithm was adaptive boosting. EEG data from 24 hours before IVH detection proved predictive with an area under the receiver operating characteristic curve of 93%, an accuracy of 91%, and a Kappa value of 0.85. The most informative features were the slow varying instantaneous frequency and amplitude in the Delta frequency band.

The authors have declared no competing interest.

This work was funded by the European Commission [Grant Agreement Number: EU H2020 MSCA-ITN-2018-#813483, INte-grating Functional Assessment measures for Neonatal Safeguard (INFANS)].

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This retrospective case-control study was conducted at the Neonatal Intensive Care Unit (NICU) of the Wilhelmina Children's Hospital, Utrecht, and the data obtained between 2009 and 2017. After the medical ethical board of the University Medical Center (UMC) Utrecht (14-335/C) reviewed the protocol, they approved waiving the need for written informed consent.

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