Early neurodevelopmental outcomes of preterm infants with intraventricular haemorrhage and periventricular leukomalacia

IF 1.6 4区医学 Q2 PEDIATRICS Journal of paediatrics and child health Pub Date : 2024-08-26 DOI:10.1111/jpc.16654

Nicole SC Ng, Abdul Razak, Preethi Chandrasekharan, Glenda McLean, Vathana Sackett, Lindsay Zhou, Pramod Pharande, Atul Malhotra

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Abstract

Aim

Intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL) in preterm infants are associated with an increased risk of long-term neurodevelopmental impairments (NDI) and cerebral palsy (CP). However, little is known about their impact on early neurodevelopmental outcomes despite increasing evidence highlighting the feasibility and importance of early NDI/CP diagnosis. We aimed to determine the early neurodevelopmental outcomes of preterm infants with IVH and PVL.

Methods

This was a retrospective single-centre cohort study of preterm infants born at <29 weeks gestation or <1000 g birth weight who attended an Early Neurodevelopment Clinic at 3 to 4 months of corrected age. Primary outcomes of early NDI and CP/high-risk CP diagnoses based on Prechtl's General Movements Assessment and the Hammersmith Infant Neurological Examination were compared between infants without IVH and infants with mild IVH (grades I-II), severe IVH (grades III-IV), and severe brain injury (SBI; severe IVH or cystic PVL).

Results

Of 313 infants, 52.1% (n = 163), 41.2% (n = 129), 6.7% (n = 21) and 8.6% (n = 27) had no IVH, mild IVH, severe IVH and SBI, respectively. The adjusted odds of early CP/high-risk CP diagnosis were significantly higher in infants with severe IVH (aOR 6.07, 95% CI 1.50–24.50) and SBI (aOR 15.28, 95% CI 3.70–63), but not in those with mild IVH (aOR 1.24, 95% CI 0.49–3.10). However, the adjusted odds of any early NDI were similar across groups.

Conclusion

Preterm infants with severe IVH and SBI are at increased risk of early CP/high-risk of CP diagnosis at 3 to 4 months of corrected age.

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患有脑室内出血和脑室周围白质异常的早产儿的早期神经发育结果。

目的：早产儿脑室内出血（IVH）和脑室周围白质异常（PVL）与长期神经发育障碍（NDI）和脑瘫（CP）的风险增加有关。然而，尽管越来越多的证据强调了早期 NDI/CP 诊断的可行性和重要性，但人们对它们对早期神经发育结果的影响却知之甚少。我们旨在确定 IVH 和 PVL 早产儿的早期神经发育结局：方法：这是一项针对早产儿的回顾性单中心队列研究：在313名婴儿中，52.1%（n = 163）、41.2%（n = 129）、6.7%（n = 21）和8.6%（n = 27）的婴儿无IVH、轻度IVH、重度IVH和SBI。在重度 IVH（aOR 6.07，95% CI 1.50-24.50）和 SBI（aOR 15.28，95% CI 3.70-63）的婴儿中，早期诊断出 CP/高危 CP 的调整后几率明显较高，但在轻度 IVH 的婴儿中却不明显（aOR 1.24，95% CI 0.49-3.10）。然而，各组婴儿发生任何早期 NDI 的调整后几率相似：结论：患有重度IVH和SBI的早产儿在3-4个月矫正年龄时被诊断为早期CP/高危CP的风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.