TY - JOUR
T1 - Punctate white matter lesions of preterm infants
T2 - Risk factor analysis
AU - Parodi, Alessandro
AU - Malova, Mariya
AU - Cardiello, Valentina
AU - Raffa, Sarah
AU - Re, Martina
AU - Calevo, Maria Grazia
AU - Severino, Mariasavina
AU - Tortora, Domenico
AU - Morana, Giovanni
AU - Rossi, Andrea
AU - Ramenghi, Luca Antonio
N1 - Copyright © 2019 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
PY - 2019/9
Y1 - 2019/9
N2 - AIM: Punctate white matter lesions (PWML) are frequently detected in preterm infants undergoing brain MRI at term equivalent age (TEA). The aims of this study were to assess prevalence of PWML and to identify risk factors for PWML in VLBW infants.METHODS: Brain MRI scans obtained at TEA and clinical charts of a consecutive sample of very low birth weight (VLBW) infants admitted to Gaslini Children's Hospital NICU between 2012 and 2016 were retrospectively analyzed. MRI protocol included Susceptibility Weighted Imaging (SWI) sequence in order to identify hemosiderin depositions as a result of previous microbleeds. PWML were classified according to their number (≤6 lesions and >6 lesions) and signal characteristics (SWI+ lesions and SWI- lesions). Univariate and multivariable analysis were performed in order to identify risk factors for PWML (as a whole) and for each subgroup of PWML.RESULTS: 321 VLBW infants were included. PWML were identified in 61 subjects (19%), 26 of whom (8% of the study population) had more than 6 lesions. Risk factors for PWML (as a whole) were higher birth weight (OR = 1.001; p = 0.04) and absent or incomplete antenatal steroid course (OR = 2.13; p = 0.02). Risk factors for >6 PWML were need for intubation (OR = 11.9; p = 0.003) and higher Apgar score at 5 min (OR = 1.8; p = 0.02). Presence of GMH-IVH was the only identified risk factor for SWI + lesions.CONCLUSIONS: Our results confirm the high prevalence of PWML among VLBW infants. Differentiation between SWI+ and SWI- lesions is crucial as they have different risk factors and may likely represent two different entities.
AB - AIM: Punctate white matter lesions (PWML) are frequently detected in preterm infants undergoing brain MRI at term equivalent age (TEA). The aims of this study were to assess prevalence of PWML and to identify risk factors for PWML in VLBW infants.METHODS: Brain MRI scans obtained at TEA and clinical charts of a consecutive sample of very low birth weight (VLBW) infants admitted to Gaslini Children's Hospital NICU between 2012 and 2016 were retrospectively analyzed. MRI protocol included Susceptibility Weighted Imaging (SWI) sequence in order to identify hemosiderin depositions as a result of previous microbleeds. PWML were classified according to their number (≤6 lesions and >6 lesions) and signal characteristics (SWI+ lesions and SWI- lesions). Univariate and multivariable analysis were performed in order to identify risk factors for PWML (as a whole) and for each subgroup of PWML.RESULTS: 321 VLBW infants were included. PWML were identified in 61 subjects (19%), 26 of whom (8% of the study population) had more than 6 lesions. Risk factors for PWML (as a whole) were higher birth weight (OR = 1.001; p = 0.04) and absent or incomplete antenatal steroid course (OR = 2.13; p = 0.02). Risk factors for >6 PWML were need for intubation (OR = 11.9; p = 0.003) and higher Apgar score at 5 min (OR = 1.8; p = 0.02). Presence of GMH-IVH was the only identified risk factor for SWI + lesions.CONCLUSIONS: Our results confirm the high prevalence of PWML among VLBW infants. Differentiation between SWI+ and SWI- lesions is crucial as they have different risk factors and may likely represent two different entities.
KW - Brain/diagnostic imaging
KW - Factor Analysis, Statistical
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Infant, Premature
KW - Infant, Premature, Diseases/diagnostic imaging
KW - Infant, Very Low Birth Weight
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Pregnancy
KW - Retrospective Studies
KW - Risk Factors
KW - White Matter/diagnostic imaging
U2 - 10.1016/j.ejpn.2019.06.003
DO - 10.1016/j.ejpn.2019.06.003
M3 - Article
C2 - 31307922
VL - 23
SP - 733
EP - 739
JO - European Journal of Paediatric Neurology
JF - European Journal of Paediatric Neurology
SN - 1090-3798
IS - 5
ER -