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Integrating Clinical and Neuroimaging Markers to Predict the Onset of Posthemorrhagic Ventricular Dilatation in Preterm Neonates.
Al-Garni, Abdul Aziz; Mazara, Avneet; Stein, Nina; Mbuagbaw, Lawrence; Ajani, Olufemi; Goswami, Ipsita.
Afiliación
  • Al-Garni AA; Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
  • Mazara A; Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Stein N; Department of Medical Imaging, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
  • Mbuagbaw L; Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
  • Ajani O; Pediatric Neurosurgery, McMaster University, Hamilton, Ontario, Canada.
  • Goswami I; Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada. Electronic address: goswamii@mcmaster.ca.
Pediatr Neurol ; 159: 4-11, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39089183
ABSTRACT

BACKGROUND:

Posthemorrhagic ventricular dilatation (PHVD) is a major complication of intraventricular hemorrhage (IVH); it is associated with high risks of cerebral palsy and cognitive deficits compared with infants without PHVD. This study aims to explore the early perinatal risk factors-associated with the risk of progressive PHVD.

METHODS:

Neonates ≤29 weeks gestational age (GA) with Grade II-III IVH and periventricular hemorrhagic infarct (PVHI) between 2015 and 2021 were retrospectively reviewed. All cranial ultrasounds done within 14 days postnatal age (PNA) were assessed for grade of IVH, anterior horn width (AHW), ventricular index (VI), and thalamo-occipital index (TOD). The outcome was defined as death of any cause or VI and/or AHW and/or TOD ≥ moderate-risk zone based on an ultrasound done beyond two weeks PNA.

RESULTS:

A total of 146 infants with a mean GA of 26 ± 1.8 weeks, birth weight 900 ± 234 g were included, 46% were females. The primary outcome occurred in 56 (39%) infants; among them 17 (30%) and 11 (20%) needed ventricular reservoir and shunt insertion, respectively. The risk factors present within 14 days PNA that significantly increased the odds of developing PHVD were hemodynamically significant patent ductus arteriosus (odds ratio [OR] 6.1, 95% confidence interval [CI] 1.9 to 22), culture-proven sepsis (OR 5.4, 95% CI 1.8 to 18), Grade III IVH (OR 4.6, 95% CI 1.1 to 22), PVHI (OR 3.0, 95% CI 0.9 to 10), and VI (OR 2.1, 95% CI 1.6 to 2.9).

CONCLUSIONS:

Clinical predictors such as significant ductus arteriosus and bacterial septicemia, along with risk levels of AHW and VI measured with early cranial ultrasounds, are potential predictors of subsequent onset of PHVD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recien Nacido Prematuro / Ventrículos Cerebrales Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Neurol Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recien Nacido Prematuro / Ventrículos Cerebrales Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Neurol Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos