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Abstract
Purpose:
The aim of the study was to determine the incidence of cystic periventricular leukomalacia (PVL) and identify the risk factors for cystic PVL in preterm infants with gestational age (GA) less than 32 weeks according to gestational age group.
Methods:
The medical records and brain imaging were reviewed for preterm infants with less than 32 weeks GA who lived more than 4 weeks and admitted to the neonatal intensive care unit at Inje University Sanggye Paik Hospital from January 2009 to June 2015. We determined the incidence and the risk factors for the development of cystic PVL in preterm infants according to GA group. Results: Incidence of cystic PVL was 15.1% (26/172). Multivariate analysis showed that intraventricular hemorrhage (IVH) [P=0.006, odds ratio (OR) 5.478, 95% confidence interval (CI) 1.641-18.285), oxygen uses over 28 days (P=0.025, OR 3.086, 95% CI 1.152-8.264), and NEC (P=0.042, OR 3.731, 95% CI 1.047-13.333) were independent risk factors for the developmental of cystic PVL. Subgroup analysis showed that pregnancy-induce hypertension and IVH were independent risk factors in preterm infants with GA of less than 28 weeks. Also, oxygen uses over 28 days and culture proven sepsis were independent risk factors in preterm infants with GA of 28+0-31+6 weeks.
Conclusion:
These results suggest that pregnancy-induce hypertension and IVH may increase the risk for the subsequent development of cystic PVL in preterm infants with GA of less than 28 weeks, and oxygen uses over 28 days and culture proven sepsis may increase in preterm infants with GA of 28+0-31+6 weeks.
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Table 1.
Analysis of Risk Factors Associated with Cystic PVL in Preterm Infants with Gestational Ages of Less than 32 Weeks
Values are expressed as number (%) or medians and ranges in square brackets. Abbreviations: PVL, periventricular leukomalacia; PROM, premature rupture of membrane; PIH, pregnancy induced hypertension; IUGR, intrauterine growth restriction; IVH, intraventricular hemorrhage; RDS, respiratory distress syndrome; RBC, red blood cell; NEC, necrotizing enterocolitis.
Table 2.
Multiple Logistic Regression Analysis of Risk Factors Associated with Cystic in Preterm Infants with Gestational Ages of Less than 32 Weeks
| Odds Ratio | 95% confidence Interval | P-Value | |
|---|---|---|---|
| VH (≥grade 2) | 5.478 | 1.641-18.285 | 0.006 |
| Oxygen uses ≥28 days | 3.086 | 1.152-8.264 | 0.025 |
| NEC (≥stage 2) | 3.731 | 1.047-13.333 | 0.042 |
Table 3.
Subgroup Analysis of Prenatal and Neonatal Risk Factors Associated with Cystic PVL in Preterm Infants with Gestational Ages of Less Than 28 Weeks and Gestational Ages of 28+0-31+6 Weeks
Table 4.
Multiple Logistic Regression Subgroup Analysis of Risk Factors Associated with Cystic PVL in Preterm Infants with Gestational Ages of Less than 32 Weeks Preterm Infants with Gestational Ages of Less than 28 Weeks
∗This analysis was performed while controlling for oxygen uses ≥28 days, culture proven sepsis, rotavirus infection, and lowest platelet count during admission <100,000/mm3. Abbreviations: PVL, periventricular leukomalacia; PIH, pregnancy induced hypertension; IVH, intraventricular hemorrhage; IUGR, intrauterine growth restriction; RBC, red blood cell.
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