Document resource
Objectives Infants born preterm or growth-restricted are at increased risk for poor neurodevelopmental outcomes, especially in low-resource settings. Resting-state electroencephalography (EEG) offers an objective tool for early detection of brain function differences. This study examined whether preterm birth and birth weight-for-age z-score (BWZ) predict resting-state EEG power at 24 months in rural Ethiopia.Methods Within the Longitudinal Infant Growth and Development (LIDG) study ( NCT06296238), we collected EEG data using a 32-channel Enobio system from children at 24 (±3) months. Preterm birth was defined as <37 weeks gestation. BWZ was categorized per INTERGROWTH-21st standards: <-2, ≥-2 to <-1, ≥-1 to ≤1, and >1. EEGs were processed using an adapted miniMADE pipeline, and alpha (6–11 Hz) and beta (20–30 Hz) absolute power were computed for frontal and posterior regions. Quantile regression (median) was used to estimate associations, adjusted for sex and corrected age. Spectral parameterization examined periodic components.Results Out of 187 EEGs, 169 (90%) were analyzable. Of these, 14 were preterm. No significant EEG power differences were found between preterm and full-term children. However, children with BWZ >1 had significantly higher frontal (β = 2.97, 95% CI: -0.06 to 6.00) and posterior (β = 6.23, 95% CI: 2.42 to 10.05) alpha power compared to the reference group (BWZ ≥-1 to ≤1). Spectral analysis confirmed stronger 1/f-adjusted alpha peaks in the BWZ >1 group.Conclusions Larger birth size may be linked to increased resting-state alpha power at 24 months, suggesting early neurodevelopmental advantages detectable via EEG in low-resource settings.