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Periventricular Hemorrhagic Infarction in Very Preterm Infants: Characteristic Sonographic Findings and Association with Neurodevelopmental Outcome at Age 2 Years
- Source :
- The Journal of Pediatrics, 217, 79. Mosby Inc.
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objective: To describe the sonographic characteristics of periventricular hemorrhagic infarction (PVHI) and their association with mortality and neurodevelopmental disability in very preterm infants born in 2008-2013. Study design: Retrospective multicenter observational cohort study. Diagonal PVHI size was measured and severity score assessed. PVHI characteristics were scored and temporal trends were assessed. Neurodevelopmental outcome at 2 years of corrected age was assessed using either the Bayley Scales of Infant and Toddler Development, Third Edition or the Griffiths Mental Development Scales. Multigroup analyses were applied as appropriate. Results: We enrolled 160 infants with median gestational age of 26.6 weeks. PVHI was mostly unilateral (90%), associated with an ipsilateral grade III intraventricular hemorrhage (84%), and located in the parietal lobe (51%). Sixty-four (40%) infants with PVHI died in the neonatal period. Of the survivors assessed at 2 years of corrected age, 65% had normal cognitive and 69% had normal motor outcomes. The cerebral palsy rate was 42%. The composite outcome of death or severe neurodevelopmental disability was observed in 58%, with no trends over the study period (P = .6). Increasing PVHI severity score was associated with death (P < .001). Increasing PVHI size and severity score were negatively associated with gross motor scores (P = .01 and .03, respectively). Trigone involvement was associated with cerebral palsy (41% vs 14%; P = .004). Associated posthemorrhagic ventricular dilation (36%) was an independent risk factor for poorer cognitive and motor outcomes (P < .001 for both). Conclusions: Increasing PVHI size and severity score were predictive of less optimal gross motor outcome and death in very preterm infants.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Developmental Disabilities
Gross motor skill
Gestational Age
Infant, Premature, Diseases
Bayley Scales of Infant Development
Cerebral Ventricles
preterm infant
Cerebral palsy
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Humans
Medicine
Pediatrics, Perinatology, and Child Health
030212 general & internal medicine
Toddler
periventricular hemorrhagic infarction
Cerebral Hemorrhage
Retrospective Studies
Ultrasonography
business.industry
Cerebral Palsy
Infant, Newborn
Parietal lobe
Infant
Gestational age
Cerebral Infarction
medicine.disease
Perinatology
and Child Health
Intraventricular hemorrhage
Child, Preschool
Infant, Extremely Premature
Pediatrics, Perinatology and Child Health
Female
cranial ultrasonography
business
Infant, Premature
Cohort study
Subjects
Details
- ISSN :
- 00223476
- Volume :
- 217
- Database :
- OpenAIRE
- Journal :
- The Journal of Pediatrics
- Accession number :
- edsair.doi.dedup.....0efe068e805065b28db276a66ca12faf