CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants

被引：1

作者：

Drommelschmidt, Karla ^{[1
,2
]}

Mayrhofer, Thomas ^{[3
]}

Mueller, Hanna ^{[5
]}

Foldyna, Borek ^{[4
]}

Raudzus, Janika ^{[3
]}

Goericke, Sophia L. ^{[6
]}

Schweiger, Bernd ^{[6
]}

Sirin, Selma ^{[7
]}

机构：

[1] Univ Duisburg Essen, Univ Hosp Essen, Dept Pediat & Neonatol Pediat Intens Care Pediat 1, Hufelandstr 55, D-45147 Essen, Germany

[2] Univ Duisburg Essen, Univ Hosp Essen, Ctr Translat Neuro & Behav Sci cTNBS, Essen, Germany

[3] Stralsund Univ Appl Sci, Sch Business Studies, Schwedenschanze 15, D-18435 Stralsund, Germany

[4] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, Cardiovasc Imaging Res Ctr, 55 Fruit St, Boston, MA 02114 USA

[5] Univ Hosp Tuebingen, Dept Pediat, Div Neonatol, Calwerstr 7, D-72076 Tubingen, Germany

[6] Univ Duisburg Essen, Univ Hosp Essen, Dept Diagnost & Intervent Radiol & Neuroradiol, Hufelandstr 55, D-45147 Essen, Germany

[7] Univ Zurich, Univ Childrens Hosp Zurich, Dept Diagnost Imaging, Steinwiesstr 75, CH-8032 Zurich, Switzerland

来源：

SCIENTIFIC REPORTS | 2025年 / 15卷 / 01期

关键词：

Pediatric research; Brain injuries; Magnetic resonance imaging; Neurodevelopmental outcomes; Preterm infants; LOW-BIRTH-WEIGHT; ACTIVE PERINATAL-CARE; INTRAVENTRICULAR HEMORRHAGE; WHITE-MATTER; TERM; AGE; CONSEQUENCES; SURVIVAL; UPDATE; IMPACT;

D O I：

10.1038/s41598-025-02539-1

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Neurological impairment is high after preterm birth. This study evaluates the impact and interplay of cMRI-detected brain injuries (BI) and clinical risk factors on neurodevelopmental outcomes and extracts the most important key factors. A retrospective analysis was conducted on risk factors (perinatal/neonatal, cMRI-detected BI) for adverse motor (MO) and cognitive (CO) outcomes (Bayley Scales of Infant Development, 24 months corrected age) in a tertiary center cohort (2009-2018) of very preterm infants (< 32 weeks of gestation) using uni-/multivariable regression models. We included 342 infants (mean gestational age:28.0 +/- 2.3 weeks; male:49%). Significant clinical predictors for MO/CO included GA, birthweight, APGAR score, catecholamine treatment, ventilation, retinopathy of prematurity, transfusion of red blood cells (RBCs), bronchopulmonary dysplasia, surgery, and patent ductus arteriosus interventions (all p < 0.01/p < 0.01), surfactant (MO: p = 0.037), and sepsis (p < 0.001/p = 0.016). (Severe) cMRI-detected BIs (> 1, all p < 0.05) and not only severe intraventricular hemorrhage (IVH) III degrees/III degrees+PVHI and ventricular dilatation (VD) (all p < 0.05), but also mild/moderate injuries like IVH II degrees (p < 0.001/p < 0.024), cerebellar hemorrhage (CO: p = 0.028), and moderate VD (MO: p = 0.005) significantly impacted outcomes. Independent key factors were > 1 severe cMRI-detected BI (MO/CO:-11.27/-10.3 score points (sp), p = 0.021/0.043), APGAR score (10 min, MO/CO:+5.3/+4.45 sp/point, p < 0.001/p < 0.001), surfactant administration (MO:+4.88 sp, p = 0.031), and transfusion of RBCs (MO/CO:-1.69/-1.96 sp/transfusion, p = 0.006/p < 0.001). In conclusion, combining imaging and clinical (key) risk factors is important for risk stratification of preterm infants. Even mild BI, like IVH II degrees, significantly contributes to adverse outcomes, underlining the importance of cMRI.

引用

页数：20

共 58 条

[1] MRI Findings at Term-Corrected Age and Neurodevelopmental Outcomes in a Large Cohort of Very Preterm Infants [J].