Neurodevelopmental Outcome of Infants With Unilateral or Bilateral Periventricular Hemorrhagic Infarction

被引:77
作者
Maitre, Nathalie L. [1 ]
Marshall, Diane D. [2 ]
Price, Wayne A. [2 ]
Slaughter, James C. [3 ]
O'Shea, Thomas M. [4 ]
Maxfield, Charles [5 ,6 ]
Goldstein, Ricki F. [5 ,6 ]
机构
[1] Monroe Carell Jr Childrens Hosp Vanderbilt, Dept Pediat, Div Neonatol, Nashville, TN 37232 USA
[2] Univ N Carolina Hosp, Dept Pediat, Chapel Hill, NC USA
[3] Vanderbilt Univ, Dept Biostat, Nashville, TN USA
[4] Wake Forest Univ, Dept Pediat, Winston Salem, NC 27109 USA
[5] Duke Univ, Med Ctr, Dept Pediat, Durham, NC 27710 USA
[6] Duke Univ, Med Ctr, Dept Radiol, Durham, NC 27710 USA
关键词
ultrasonography; grade 4 intraventricular hemorrhage; preterm infants; outcome; LOW-BIRTH-WEIGHT; INTRAVENTRICULAR HEMORRHAGE; PRETERM INFANTS; BRAIN-INJURY; CRANIAL ULTRASOUND; INTRAPARENCHYMAL ECHODENSITIES; PREMATURE-INFANTS; HEAD ULTRASOUND; PLASTICITY; LESIONS;
D O I
10.1542/peds.2009-0953
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: Periventricular hemorrhagic infarction (PVHI) is a major contributing factor to poor neurodevelopmental outcomes in preterm infants. We hypothesized that surviving infants with unilateral PVHI would have more favorable outcomes than those with bilateral PVHI. METHODS: This was a multicenter, retrospective study of infants who were admitted to 3 NICUs in North Carolina from 1998 to 2004. The clinical course and late neuroimaging studies and neurodevelopmental outcomes of 69 infants who weighed <1500 g and had confirmed PVHI on early cranial ultrasonography were reviewed. A predictive model for Bayley Scales of Infant Development, Second Edition, Mental Developmental Index (MDI) <70 was constructed by using radiologic and clinical variables. RESULTS: Infants with unilateral PVHI had higher median MDI (82 vs 49) and Psychomotor Developmental Index (53 vs 49) than infants with bilateral PVHI. Infants with unilateral PVHI were less likely to have severe cerebral palsy (adjusted odds ratio: 0.15 [95% confidence interval (CI): 0.05-0.45]) than infants with bilateral PVHI. Infants who had unilateral PVHI and developed periventricular leukomalacia and retinopathy of prematurity that required surgery had an increased probability of having MDI <70 compared with those without these complications (probability of MDI <70: 89% [95% CI: 0.64-1.00] vs 11% [95% CI: 0.01-0.28]). CONCLUSIONS: Infants with unilateral PVHI had better motor and cognitive outcomes than infants with bilateral PVHI. By combining laterality of PVHI, periventricular leukomalacia, and retinopathy of prematurity it is possible to estimate the probability of having an MDI <70, which will assist clinicians when counseling families. Pediatrics 2009; 124: e1153-e1160
引用
收藏
页码:E1153 / E1160
页数:8
相关论文
共 41 条
[1]   Neurodevelopmental outcomes of preterm infants [J].
Allen, Marilee C. .
CURRENT OPINION IN NEUROLOGY, 2008, 21 (02) :123-128
[2]   Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s [J].
Anderson, P ;
Doyle, LW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (24) :3264-3272
[3]  
[Anonymous], 1994, An introduction to the bootstrap: CRC press
[4]  
[Anonymous], 2006, Bayley Scales of Infant and Toddler Development
[5]   Does Obstetric Brachial Plexus Injury Influence Speech Dominance? [J].
Auer, Tibor ;
Pinter, Sandor ;
Kovacs, Norbert ;
Kalmar, Zsuzsanna ;
Nagy, Ferenc ;
Horvath, Reka A. ;
Koszo, Balazs ;
Kotek, Gyula ;
Perlaki, Gabor ;
Koves, Maria ;
Kalman, Bernadette ;
Komoly, Samuel ;
Schwarcz, Attila ;
Woermann, Friedrich G. ;
Janszky, Jozsef .
ANNALS OF NEUROLOGY, 2009, 65 (01) :57-66
[6]   Neurodevelopmental outcome in survivors of periventricular hemorrhagic infarction [J].
Bassan, Haim ;
Limperopoulos, Catherine ;
Visconti, Karen ;
Mayer, D. Luisa ;
Feldman, Henry A. ;
Avery, Lauren ;
Benson, Carol B. ;
Stewart, Jane ;
Ringer, Steven A. ;
Soul, Janet S. ;
Volpe, Joseph J. ;
du Plessis, Adre J. .
PEDIATRICS, 2007, 120 (04) :785-792
[7]   Periventricular hemorrhagic infarction: Risk factors and neonatal outcome [J].
Bassan, Haim ;
Feldman, Henry A. ;
Limperopoulos, Catherine ;
Benson, Carol B. ;
Ringer, Steven A. ;
Veracruz, Elaine ;
Soul, Janet S. ;
Volpe, Joseph J. ;
du Plessis, Adre J. .
PEDIATRIC NEUROLOGY, 2006, 35 (02) :85-92
[8]   LARGE POSTNATALLY ACQUIRED PORENCEPHALIC CYSTS - UNEXPECTED DEVELOPMENTAL OUTCOMES [J].
BLACKMAN, JA ;
MCGUINNESS, GA ;
BALE, JF ;
SMITH, WL .
JOURNAL OF CHILD NEUROLOGY, 1991, 6 (01) :58-64
[9]   Clinical data predict neurodevelopmental outcome better than head ultrasound in extremely low birth weight infants [J].
Broitman, Eduardo ;
Ambalavanan, Namasivayam ;
Higgins, Rosemary D. ;
Vohr, Betty R. ;
Das, Abhik ;
Bhaskar, Brinda ;
Murray, Kennan ;
Hintz, Susan R. ;
Carlo, Waldemar A. .
JOURNAL OF PEDIATRICS, 2007, 151 (05) :500-505
[10]   Developmental plasticity after right hemispherectomy in an epileptic adolescent with early brain injury [J].
Chiricozzi, F ;
Chieffo, D ;
Battaglia, D ;
Iuvone, L ;
Acquafondata, C ;
Cesarini, L ;
Sacco, A ;
Chiera, R ;
Di Rocco, C ;
Guzzetta, F .
CHILDS NERVOUS SYSTEM, 2005, 21 (11) :960-969