Clinical characteristics and long-term neurodevelopmental outcomes of leukomalacia in preterm infants and term infants: a cohort study.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY Journal of Neurodevelopmental Disorders Pub Date : 2023-08-07 DOI:10.1186/s11689-023-09489-7

Juan Song, Yuyang Yue, Huiqing Sun, Ping Cheng, Falin Xu, Bingbing Li, Kenan Li, Changlian Zhu

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Abstract

Background: Leukomalacia is a serious form of neonatal brain injury that often leads to neurodevelopmental impairment, and studies on neonatal leukomalacia and its long-term outcomes are lacking. The aim of this study was to analyze the clinical manifestations, imaging features, and long-term neurodevelopmental outcomes in preterm infants and term infants with leukomalacia.

Methods: Newborns diagnosed with leukomalacia by head magnetic resonance imaging (MRI) and who were admitted to intensive care units from January 2015 to June 2020 were enrolled. All infants were followed up to June 2022 (2-7 years old), and their neurodevelopmental outcomes were evaluated. The clinical data and long- term outcomes of preterm infants and term infants was analyzed by Chi-square tests.

Results: A total of 218 surviving infants with leukomalacia including 114 preterm infants and 104 term infants completed the follow-up. The major typesof leukomalacia on MRI were periventricular leukomalacia in the preterm group and subcortical cystic leukomalacia in the term group, respectively (χ² = 55.166; p < 0.001). When followed up to 2-7 years old, the incidence of neurodevelopmental impairment in the preterm group and term group was not significantly different (χ² = 0.917; p = 0.338). However, the incidence of cerebral palsy (CP) in the preterm group was significantly higher (χ² = 4.896; p = 0.027), while the incidence of intellectual disability (ID) (χ² = 9.445; p = 0.002), epilepsy (EP) (χ² = 23.049; p < 0.001), and CP combined with ID andEP (χ² = 4.122; p = 0.042) was significantly lower than that in the term group.

Conclusions: Periventricular leukomalacia mainly occurred in preterm infants while subcortical cystic leukomalacia was commonly seen in term infants. Although the long-term neurodevelopmental outcomes of leukomalacia were both poor, preterm infants were more prone to CP, while term infants were more prone to ID, EP, and the combination of CP with ID and EP.

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早产儿和足月婴儿白血病软化症的临床特征和长期神经发育结局:一项队列研究。

背景:白质软化症是一种严重的新生儿脑损伤，常导致神经发育障碍，目前缺乏对新生儿白质软化症及其长期预后的研究。本研究的目的是分析白血病软化症的早产儿和足月婴儿的临床表现、影像学特征和长期神经发育结局。方法:选取2015年1月至2020年6月在重症监护病房接受头部磁共振成像(MRI)诊断为白质软化症的新生儿为研究对象。所有婴儿随访至2022年6月(2-7岁)，并评估其神经发育结局。采用卡方检验对早产儿和足月儿的临床资料和远期结局进行分析。结果:218例存活的白质软化患儿完成随访，其中早产儿114例，足月患儿104例。MRI上显示的白质软化类型以早产儿脑室周围白质软化和足月组皮层下囊性白质软化为主，差异有统计学意义(χ2 = 55.166;p 2 = 0.917;p = 0.338)。然而，早产组脑瘫(CP)的发生率显著高于对照组(χ2 = 4.896;p = 0.027)，智力残疾(ID)发生率(χ2 = 9.445;p = 0.002)、癫痫(EP) (χ2 = 23.049;p 2 = 4.122;P = 0.042)显著低于term组。结论:脑室周围白质软化多见于早产儿，而皮层下囊性白质软化常见于足月儿。虽然白血病软化症的长期神经发育结局均较差，但早产儿更容易发生CP，而足月儿更容易发生ID、EP以及CP合并ID和EP。

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来源期刊

Journal of Neurodevelopmental Disorders 医学-临床神经学

CiteScore

7.60

自引率

4.10%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Neurodevelopmental Disorders is an open access journal that integrates current, cutting-edge research across a number of disciplines, including neurobiology, genetics, cognitive neuroscience, psychiatry and psychology. The journal’s primary focus is on the pathogenesis of neurodevelopmental disorders including autism, fragile X syndrome, tuberous sclerosis, Turner Syndrome, 22q Deletion Syndrome, Prader-Willi and Angelman Syndrome, Williams syndrome, lysosomal storage diseases, dyslexia, specific language impairment and fetal alcohol syndrome. With the discovery of specific genes underlying neurodevelopmental syndromes, the emergence of powerful tools for studying neural circuitry, and the development of new approaches for exploring molecular mechanisms, interdisciplinary research on the pathogenesis of neurodevelopmental disorders is now increasingly common. Journal of Neurodevelopmental Disorders provides a unique venue for researchers interested in comparing and contrasting mechanisms and characteristics related to the pathogenesis of the full range of neurodevelopmental disorders, sharpening our understanding of the etiology and relevant phenotypes of each condition.