Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Clinical Factors and Neurodevelopmental Outcomes between Early- and Late-Onset Periventricular Leukomalacia in Very Low Birth Weight Infants

  • Bae, Mihye (Division of Neonatology, Department of Pediatrics, Pusan National University School of Medicine) ;
  • Lee, Narae (Division of Neonatology, Department of Pediatrics, Pusan National University School of Medicine) ;
  • Han, Young Mi (Division of Neonatology, Department of Pediatrics, Pusan National University School of Medicine) ;
  • Park, Kyung Hee (Division of Neonatology, Department of Pediatrics, Pusan National University School of Medicine) ;
  • Byun, Shin Yun (Division of Neonatology, Department of Pediatrics, Pusan National University School of Medicine)
  • Received : 2018.09.27
  • Accepted : 2019.02.12
  • Published : 2019.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To analyze and compare the clinical factors and neurodevelopmental outcomes compare early- and late-onset periventricular leukomalacia (PVL) in very low birth weight infants (VLBWI). Methods: We performed a retrospective study involving 199 newborn infants weighing <1,500 g admitted to the neonatal intensive care unit between March 2009 and December 2015. VLBWI with PVL were categorized into early- and late-onset PVL groups based on the time of diagnosis based on 28 days of age. We analyzed the clinical factors and neurodevelopmental outcomes between the groups. Results: The incidence rate of PVL was 10.1% (16/158). The Apgar score at 1 minute and the mean duration of tocolytic therapy were associated with the development of PVL. The incidence rate of premature rupture of membranes (PROM) was significantly higher in the early-onset PVL group (P=0.041). No significant differences were observed in neurodevelopmental outcomes between the early- and late-onset PVL groups. Conclusion: Results suggest that a higher incidence of PROM was associated with clinical characteristics in the early-onset PVL group. No significant intergroup differences were observed in neurodevelopmental outcomes; however, the Bayley Scales of Infant Development-III scores were lower in the early-onset PVL group.

Keywords

Acknowledgement

이 연구는 2018년도 부산대학교병원 임상연구비 지원으로 이루어졌습니다.

References

  1. Sung TJ. Recent advances between prenatal inflammatory response and prematurity associated complications. Korean J Perinatol 2013;24:127-32. https://doi.org/10.14734/kjp.2013.24.3.127
  2. Andrews WW, Cliver SP, Biasini F, Peralta-Carcelen AM, Rector R, Alriksson-Schmidt AI, et al. Early preterm birth: association between in utero exposure to acute inflammation and severe neurodevelopmental disability at 6 years of age. Am J Obstet Gynecol 2008;198:466.e1-11. https://doi.org/10.1016/j.ajog.2007.12.031
  3. Kim S, Song IG, Kim KL, Kim YJ, Shin SH, Lee SH, et al. Outpatient follow-up status and neurodevelopmental outcomes of extremely low birth weight infants. J Korean Soc Neonatol 2012;19:17-25. https://doi.org/10.5385/jksn.2012.19.1.17
  4. Tsimis ME, Johnson CT, Raghunathan RS, Northington FJ, Burd I, Graham EM. Risk factors for periventricular white matter injury in very low birthweight neonates. Am J Obstet Gynecol 2016;214:380.e1-6. https://doi.org/10.1016/j.ajog.2015.09.108
  5. Wang LY, Wang YL, Wang ST, Huang CC. Using the Alberta Infant Motor Scale to early identify very low-birth-weight infants with cystic periventricular leukomalacia. Brain Dev 2013;35:32-7. https://doi.org/10.1016/j.braindev.2011.08.012
  6. Al Tawil KI, El Mahdy HS, Al Rifai MT, Tamim HM, Ahmed IA, Al Saif SA. Risk factors for isolated periventricular leukomalacia. Pediatr Neurol 2012;46:149-53. https://doi.org/10.1016/j.pediatrneurol.2011.12.008
  7. Resch B, Neubauer K, Hofer N, Resch E, Maurer U, Haas J, et al. Episodes of hypocarbia and early-onset sepsis are risk factors for cystic periventricular leukomalacia in the preterm infant. Early Hum Dev 2012;88:27-31. https://doi.org/10.1016/j.earlhumdev.2011.06.011
  8. Resch B, Vollaard E, Maurer U, Haas J, Rosegger H, Muller W. Risk factors and determinants of neurodevelopmental outcome in cystic periventricular leucomalacia. Eur J Pediatr 2000;159:663-70. https://doi.org/10.1007/PL00008403
  9. Chey MJ, Shim GH. Risk factors of cystic periventricular leukomalacia in preterm infants with gestational ages of less than 32 weeks according to gestational age group. Korean J Perinatol 2016;27:36-44. https://doi.org/10.14734/kjp.2016.27.1.36
  10. Oda N, Takeuchi K, Tanaka A, Maruo T. Obstetric risk factors associated with the development of periventricular leukomalacia in preterm infants born to mothers complicated by placenta previa. Fetal Diagn Ther 2008;24:345-8. https://doi.org/10.1159/000161573
  11. Denzler A, Burkhardt T, Natalucci G, Zimmermann R. Latency after preterm prelabor rupture of the membranes: increased risk for periventricular leukomalacia. J Pregnancy 2014;2014:874984. https://doi.org/10.1155/2014/874984
  12. Gibbs RS, Blanco JD, St Clair PJ, Castaneda YS. Quantitative bacteriology of amniotic fluid from women with clinical intra-amniotic infection at term. J Infect Dis 1982;145:1-8. https://doi.org/10.1093/infdis/145.1.1
  13. Lee NY, Cho SJ, Park EA. Influence of antenatal magnesium sulfate exposure on perinatal outcomes in VLBW infants with maternal preeclampsia. Neonatal Med 2013;20:28-34. https://doi.org/10.5385/nm.2013.20.1.28
  14. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978;92:529-34. https://doi.org/10.1016/S0022-3476(78)80282-0
  15. Walsh MC, Kliegman RM, Fanaroff AA. Necrotizing enterocolitis: a practitioner's perspective. Pediatr Rev 1988;9:219-26. https://doi.org/10.1542/pir.9-7-219
  16. Shim JW, Jin HS, Bae CW. Changes in survival rate for very-low-birth-weight infants in Korea: Comparison with other countries. J Korean Med Sci 2015;30 Suppl 1:S25-34. https://doi.org/10.3346/jkms.2015.30.S1.S25
  17. Cho JH, Choi SK, Chung SH, Choi YS, Bae CW. Changes in neonatal and perinatal vital statistics during last 5 decades in republic of Korea: compared with OECD nations. Neonatal Med 2013;20:402-12. https://doi.org/10.5385/nm.2013.20.4.402
  18. Ahn SY, Shim SY, Sung IK. Intraventricular hemorrhage and post hemorrhagic hydrocephalus among very-low-birth-weight infants in Korea. J Korean Med Sci 2015;30 Suppl 1:S52-8. https://doi.org/10.3346/jkms.2015.30.S1.S52
  19. Perlman JM, Risser R, Broyles RS. Bilateral cystic periventricular leukomalacia in the premature infant: associated risk factors. Pediatrics 1996;97(6 Pt 1):822-7.
  20. Volpe JJ. Neurobiology of periventricular leukomalacia in the premature infant. Pediatr Res 2001;50:553-62. https://doi.org/10.1203/00006450-200111000-00003
  21. O'Shea TM, Allred EN, Dammann O, Hirtz D, Kuban KC, Paneth N, et al. The ELGAN study of the brain and related disorders in extremely low gestational age newborns. Early Hum Dev 2009;85:719-25. https://doi.org/10.1016/j.earlhumdev.2009.08.060
  22. Thomas W, Speer CP. Chorioamnionitis: important risk factor or innocent bystander for neonatal outcome? Neonatology 2011;99:177-87. https://doi.org/10.1159/000320170
  23. Deguchi K, Mizuguchi M, Takashima S. Immunohistochemical expression of tumor necrosis factor alpha in neonatal leukomalacia. Pediatr Neurol 1996;14:13-6. https://doi.org/10.1016/0887-8994(95)00223-5
  24. Choi EK, Park D, Kim TK, Lee SH, Bae DK, Yang G, et al. Animal models of periventricular leukomalacia. Lab Anim Res 2011;27:77-84. https://doi.org/10.5625/lar.2011.27.2.77
  25. Lee YS, Yoo DS. Cystic periventricular leukomalacia in the neonate: analysis of sequential sonographic findings and neurologic outcomes. J Korean Radiol Soc 2003;49:57-62. https://doi.org/10.3348/jkrs.2003.49.1.57
  26. de Vries LS, Eken P, Dubowitz LM. The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res 1992;49:1-6. https://doi.org/10.1016/S0166-4328(05)80189-5
  27. Pierrat V, Duquennoy C, van Haastert IC, Ernst M, Guilley N, de Vries LS. Ultrasound diagnosis and neurodevelopmental outcome of localised and extensive cystic periventricular leucomalacia. Arch Dis Child Fetal Neonatal Ed 2001;84:F151-6. https://doi.org/10.1136/fn.84.3.F151