Effects of intraventricular hemorrhage on white matter microstructural changes at term and early developmental outcomes in infants born very preterm

Yuan, Weihong; Tamm, Leanne; Harpster, Karen; Altaye, Mekibib; Illapani, Venkata Sita Priyanka; Parikh, Nehal A.

doi:10.1007/s00234-021-02708-9

Cited by 6 publications

(4 citation statements)

References 50 publications

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“…IVH is graded from I to IV according to the classification of Papile ( 7 ). Several studies have shown that III-IV IVH implies more severe pathologic injuries and that it is associated with greater adverse neurological outcomes in preterm infants ( 8 – 11 ) such as cerebral palsy (CP), intellectual ability, and impairment of academic skills. Although I-II IVH is generally considered benign, subtle impairment in subcortical white matter and decreasing cortical gray matter following I-II IVH have been identified by cerebral MRI and might influence the development of processing skills and motor coordination ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

et al. 2022

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ObjectiveIntraventricular hemorrhage (IVH) is a common complication in preterm infants and is related to neurodevelopmental outcomes. Infants with severe IVH are at higher risk of adverse neurological outcomes and death, but the effect of low-grade IVH remains controversial. The purpose of this study was to evaluate the impact of different degrees of IVH on mortality and neurodevelopmental outcomes in very preterm infants.MethodsPreterm infants with a gestational age of <30 weeks admitted to neonatal intensive care units were included. Cerebral ultrasound was examined repeatedly until discharge or death. All infants were followed up to 18–24 months of corrected age. The impact of different grades of IVH on death and neurodevelopmental disability was assessed by multiple logistic regression.ResultsA total of 1,079 preterm infants were included, and 380 (35.2%) infants had grade I-II IVH, 74 (6.9%) infants had grade III-IV IVH, and 625 (57.9%) infants did not have IVH. The mortality in the non-IVH, I-II IVH, and III-IV IVH groups was 20.1, 19.7, and 55.2%, respectively (p < 0.05), and the incidence of neurodevelopmental disabilities was 13.9, 16.1, and 43.3%, respectively (p < 0.05), at 18–24 months of corrected age. After adjusting for confounding factors, preterm infants with III-IV IVH had higher rates of cerebral palsy [26.7 vs. 2.4%, OR = 6.10, 95% CI (1.840–20.231), p = 0.003], disability [43.3 vs. 13.9%, OR = 2.49, 95% CI (1.059–5.873), p = 0.037], death [55.2 vs. 20.1%, OR = 3.84, 95% CI (2.090–7.067), p < 0.001], and disability + death [73.7 vs. 28.7%, OR = 4.77, 95% CI (2.518–9.021), p < 0.001] compared to those without IVH. However, the mortality and the incidence of neurodevelopmental disability in infants with I-II IVH were similar to those without IVH (p > 0.05).ConclusionsSevere IVH but not mild IVH increased the risk of mortality and neurodevelopmental disability in very preterm infants.

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Section: Introductionmentioning

confidence: 99%

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

et al. 2022

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“…Increased %TST having respiratory events at younger ages (32–36 and 36–40 weeks PMA) were associated with lower scores for mean approach and perceptual sensitivity. Decreased scores in pleasure and perceptual sensitivity have been shown previously in very preterm infants with complications such as gray matter abnormalities [ 41 ] and high grade intraventricular hemorrhage [ 42 ]. Although, none of the infants in our study was diagnosed with intrauterine growth restriction, major congenital and intracranial abnormality, significant intraventricular hemorrhage (Grade III or IV), or a hemodynamically significant patent ductus arteriosus, these complications are associated with adverse neurodevelopment outcomes in preterm infants.…”

Section: Discussionmentioning

confidence: 92%

Developmental consequences of short apneas and periodic breathing in preterm infants

Yee,

Siriwardhana,

Nixson

et al. 2023

J Perinatol

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Objective We investigated the relationship between respiratory events experienced before and after hospital discharge and developmental outcomes at 6 months corrected age (CA). Study design Preterm infants born between 28–32 weeks gestational age (GA) were studied at 32–36 weeks postmenstrual age (PMA), 36–40 weeks PMA, 3- and 6-months CA. Percentage total sleep time (%TST) with respiratory events (isolated apneas, sequential apneas and periodic breathing (PB)) at each study was calculated. Stepwise multiple linear regressions determined significant predictors of developmental outcomes at 6 months. Result %TST with respiratory events at term were significant predictors of language (R2 = 0.165, β = −0.416) and motor (R2 = 0.180, β = −0.485) composite scores of the Bayley Scales of Infant Development at 6 months, independent of GA, birth weight and sex. Conclusions In clinically stable very preterm infants at term equivalent age, time spent having respiratory events, was related to a reduction in language and motor outcomes at 6 months.

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“…The watershed area between the two arteries shifts as the embryo develops; in preterm infants, the subependymal area is immature and the watershed area is thus located near the lateral ventricle, whereas in mature term infants the watershed area is displaced outward toward the parasagittal area. Therefore, hypoxic-ischemic brain lesion in premature infants affects the periventricular white matter area rst, and the corresponding ICH typically involves the subependymal matrix and manifests as intraventricular hemorrhage [26,27]. The site of brain lesion of term infants is usually the paracortical subcortical area.…”

Section: Discussionmentioning

confidence: 99%

The application value of susceptibility-weighted imaging for neonatal intracranial hemorrhage

Zhang

Wang

et al. 2023

Preprint

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Objective: This study aimed to evaluate the value of susceptibility-weighted imaging (SWI) for detecting intracerebral hemorrhage (ICH). Methods: Conventional magnetic resonance imaging (MRI) and SWI were performed on 900 newborns clinically suspected of brain lesion. The chi-squared test (χ2) was used to compare the detection rates for different hemorrhage sites between conventional MRI and SWI. Term and preterm infants were also compared using the χ2 test. Results: The detection rate of ICH for SWI was higher than that for conventional MRI (24.0% vs. 19.8%, P < 0.05). Two cases misdiagnosed as ICH by conventional. MRI were confirmed by SWI to have venous malformation. intraventricular, cerebral cortical, cerebellar and subdural/epidural hemorrhage was identified by SWI at a significantly higher rate than by conventional MRI (P < 0.05). In total, 93 cases of punctate white matter lesions (PWML) were diagnosed by conventional MRI, while SWI identified 8 cases complicated with hemorrhage. The number of hemorrhagic lesions in the germinal matrix and intraventricular of premature infants was higher than in full-term infants, while the number of hemorrhagic lesions in the subarachnoid space was lower than in full-term infants (P < 0.05). Conclusion: This study showed that SWI is superior to conventional MRI for detecting ICH in neonates.

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Effects of intraventricular hemorrhage on white matter microstructural changes at term and early developmental outcomes in infants born very preterm

Cited by 6 publications

References 50 publications

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

Developmental consequences of short apneas and periodic breathing in preterm infants

The application value of susceptibility-weighted imaging for neonatal intracranial hemorrhage

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