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Trends in severe brain injury and neurodevelopmental outcome in premature newborn infants: the role of cystic periventricular leukomalacia.
Hamrick, Shannon E G; Miller, Steven P; Leonard, Carol; Glidden, David V; Goldstein, Ruth; Ramaswamy, Vijay; Piecuch, Robert; Ferriero, Donna M.
Afiliação
  • Hamrick SE; Department of Pediatrics, University of California San Francisco, CA 94143-0663, USA.
J Pediatr ; 145(5): 593-9, 2004 Nov.
Article em En | MEDLINE | ID: mdl-15520756
OBJECTIVES: To determine if the incidence of sonographically detected cystic periventricular leukomalacia (PVL) and periventricular hemorrhagic infarction (PVHI) have changed over the past decade and to determine if a decline in cystic PVL was associated with a change in neurodevelopmental outcome. STUDY DESIGN: Premature newborn infants admitted to our intensive care nursery from 1992 to 2002 were identified in a comprehensive nursery database. Premature newborn infants had routine neurosonography by means of a standardized protocol. Infants weighing < or =1500 g at birth surviving to nursery discharge were enrolled in a nursery follow-up clinic. RESULTS: Adjusting for gestational age, there was a significant decrease in cystic PVL from 1992 to 2002 (P=.003) without a concurrent decrease in PVHI (P=0.5). Cystic PVL and PVHI accounted for only 9 of the 28 cases of cerebral palsy and 12 of 90 cases of abnormal Developmental Scores in infants weighing <1500 g at birth. The decline in cystic PVL was not associated with improved developmental outcome from 1992 to 2002. CONCLUSIONS: The incidence of cystic PVL declined significantly from 1992 to 2002 at our center. Cystic PVL was detected by ultrasound in a minority of infants with abnormal neurodevelopmental outcome, indicating that other forms of cerebral injury account for the majority of abnormal neurodevelopmental outcomes in premature newborn infants.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Leucomalácia Periventricular / Encéfalo / Hemorragia Cerebral / Infarto Cerebral / Desenvolvimento Infantil Tipo de estudo: Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Leucomalácia Periventricular / Encéfalo / Hemorragia Cerebral / Infarto Cerebral / Desenvolvimento Infantil Tipo de estudo: Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos