Journal List > Perinatology > v.30(4) > 1144132

Perinatology. 2019 Dec;30(4):229-235. Korean.
Published online Dec 31, 2019.  https://doi.org/10.14734/PN.2019.30.4.229
Copyright © 2019 The Korean Society of Perinatology
Risk factors and Effect of Early Hypocarbia on the Development of Cystic Periventricular Leukomalacia in Very Low birth Weight Infants
Eun Yi Lee, MD, Jeong Mook Yeom, MD, Seung Hyun Lee, MD, Cheol Hwan So, MD and Yeon Kyun Oh, MD
Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to Yeon Kyun Oh, MD. Department of pediatrics, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. Tel: +82-63-859-1510, Fax: +82-63-853-3670, Email: oyk5412@wonkwang.ac.kr
Received Apr 25, 2019; Revised Jun 11, 2019; Accepted Oct 08, 2019.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Objective

To evaluate the risk factors and effect of early hypocarbia for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight infants.

Methods

We reviewed medical records of 187 infants with weighting less than 1,500 g who were admitted to the neonatal intensive care unit at Wonkwang University Hospital from January 2012 to December 2016 retrospectively. Twenty five infants died within 28 days of birth. Of the remaining 162 infants, we compared 21 with CPVL group who were detected by cranial ultrasonography and randomly selected 105 infants as 5 times of CPVL were matched for gestational age were enrolled in this study. For statistical analysis, univariate and multivariate analysis of perinatal, maternal, neonatal risk factors and effect of variable early hypocarbia level on development of CPVL were performed.

Results

Incidence of CPVL was 12.96% (21/162). On univariate analysis, intraventricular hemorrhage (≥grade III) (23.8% vs. 6.7%, P=0.0289), culture proven sepsis (19.1% vs. 4.8%, P=0.0417), and hospitalization (days) (73.1±42.1 vs. 57.8±22.4, P=0.0175) and PaCO2 <25 mmHg within 72 hours after birth (66.7% vs. 29.5%, P=0.0022) were associated with CPVL. And multivariate analysis showed culture proven sepsis (odds ratio [OR], 12.399; 95% confidence interval [CI] 1.563–98.348; P=0.017) and PaCO2 <25 mmHg within 72 hours after birth (OR, 8.468; 95% CI 2.150-33.358, P=0.002) were found to be independent risk factors.

Conclusion

Culture proven sepsis and early hypocarbia after birth were important risk factors on development of CPVL.

Keywords: Cystic periventricular leukomalacia; Risk factors; Hypocapnia; Infant, very low birth weight

Tables


Table 1
Comparison of Perinatal and Maternal Risk Factors between CPVL and Control Group in Very Low Birth Weight Infants
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Table 2
Comparison of Neonatal Risk Factors between CPVL and Control Group in Very Low Birth Weight Infants
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Table 3
Comparison of PaCO2 Related Risk Factors between CPVL and Control Group in Very Low Birth Weight Infants
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Table 4
Multiple Logistic Regression Analysis of Risk Factors for Development of CPVL in Very Low Birth Weight Infants
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