Brain Injury in Preterm Infants

Iliodromiti, Zoe; Zygouris, Dimitrios; Karagianni, Paraskevi; Belitsos, P.; Daniilidis, Angelos; Vrachnis, Nikolaos

doi:10.5772/52078

Cited by 3 publications

(5 citation statements)

References 82 publications

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“…Chorioamnionitis and intrauterine infection and/or inflammation are well-known risk factors for CP. Prenatal maternal chorioamnionitis is accounting for as much as 12% of cerebral palsy in term infants and 28% in premature infants [13,70,71]. According to the inflammatory hypothesis, maternal infection can lead to elevated fetal blood and brain cytokine levels, which might result in central nervous damage and subsequent CP [13].…”

Section: Prenatal Risk Factorsmentioning

confidence: 99%

Definition, Epidemiology, and Etiological Factors of Cerebral Palsy

Kurt¹

2016

Cerebral Palsy - Current Steps

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CP is not a diagnosis but an umbrella term for many clinical descriptions. It refers to a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain. The motor disorerders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition. First description was made in th century by William Little. CP prevalence is generally reported aroundper live births in both developed and developing countries even if for very different reasons . "dditionally for term children CP prevalence is per live births. This rates are -times higher in preterm birth. The etiology of CP has been reported very diverse and multifactorial as prenatal, perinatal and postnatal. The causes and risk factors are congenital, genetic, inflammatory, infectious, anoxic, traumatic and metabolic. Knowledge of the epidemiology and etiology of cerebral palsy is important. Thus, at least in some cases, early diagnosis and prevention can be achieved.

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Section: Prenatal Risk Factorsmentioning

confidence: 99%

Definition, Epidemiology, and Etiological Factors of Cerebral Palsy

Kurt¹

2016

Cerebral Palsy - Current Steps

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“…This damage involves multifocal necrosis resulting in cystic periventricular leukomalacia (PVL) or a diffuse astrogliosis and loss of myelin-producing oligodendrocytes. [5] Congenital brain anomalies could be seen during the cranial ultrasound screening, such as Dandy-Walker malformation (DWM), Chiari II malformation, agenesis of corpus callosum. [2] The aim of this study was to evaluate the value of routine cranial ultrasound screening in preterm neonates.…”

Section: Introductionmentioning

confidence: 99%

The Value of Routine Cranial Ultrasound in Preterm Neonates less than 37 weeks: A Prospective Analytical Study

Atta¹,

Ahmed

Fouad

et al. 2022

Annals of Neonatology Journal

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Background: Cranial ultrasound is a safe imaging modality that does not require sedation and can be performed bedside in preterm.Objective: To evaluate the value of routine cranial ultrasound as a routine screening in preterm neonates. Patients and methods:This was a prospective observational comparative study conducted on 50 preterm infants less than 37 weeks gestational age admitted to the Neonatal Intensive Care Unit (NICU).The cranial ultrasound (CUS) was done to all neonates in the first 4 to7 days of life & repeated at 10 to 14 days of life for detection of any cranial ultrasound abnormality and follow up for these abnormalities if present. They were divided into two groups: group I included cases with normal cranial ultrasound and group II included cases with abnormal cranial ultrasound.Results: Intraventricular hemorrhage was the most abnormal CUS findings (26.3%); followed by periventricular leukomalacia (15.8%) then intra cerebral hemorrhage, hydrocephalous & holoprosencephaly (10.5%). There was significant decrease of hemoglobin levels, significant increase in prothrombin time (P≤0.001 for all), partial thromboplastin time (P-0.003), international normalized ratio levels ( P-0.002) in neonates with abnormal CUS. There were significant increase in cases with apnea (P≤0.001), cyanosis (P-0.017) and pallor (P-0.001) in cases with abnormal US. Conclusions:Global routine cranial ultrasonography screening for all preterm neonates even if asymptomatic or not among at-risk population is highly valuable, cheap, and applicable tool investigation for detection of many neurological disorders like intraventricular hemorrhage, periventricular leukomalacia and intracerebral hemorrhages.

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“…Glutamate rising concentrations or free radical reactive species (both oxygen and hydrogen) in HIE, inflammatory cytokines such as TNF-α, IL-1b, IL-6, 12, 15, 18 from activated microglia and astrocytes and low pH in INF (including SARS-Cov2), free iron secondary to HC were extensively mentioned in both white and grey matter injuries. On a different scale, MRI images showed an association between white matter injuries and loss of the grey matter volume documented in both preterms and full-terms [ 2 , 3 ]. The most referred areas were in thalamus, basal ganglia, dentate cerebellar nuclei and hippocampus.…”

Section: Introductionmentioning

confidence: 99%

“…Many research reports associated specific MRI injury patterns with lower cut-off values for Apgar scores, birthweight and/or pH. More than two-thirds of the NE cases with brain injury occur near the birth time, and a prompt postnatal therapeutic intervention could alleviate the outcomes in newborns at risk [ 1 , 2 , 3 , 4 , 5 , 6 ]. Therefore, many scoring systems attempts based on a widely used model (the logistic regression) were proposed for different combinations of independent risk factors to assist in neonatal encephalopathy outcome prediction.…”

Section: Introductionmentioning

confidence: 99%

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A Decision-Tree Approach to Assist in Forecasting the Outcomes of the Neonatal Brain Injury

Neamţu

Visa²,

Maniu

et al. 2021

IJERPH

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Neonatal brain injury or neonatal encephalopathy (NE) is a significant morbidity and mortality factor in preterm and full-term newborns. NE has an incidence in the range of 2.5 to 3.5 per 1000 live births carrying a considerable burden for neurological outcomes such as epilepsy, cerebral palsy, cognitive impairments, and hydrocephaly. Many scoring systems based on different risk factor combinations in regression models have been proposed to predict abnormal outcomes. Birthweight, gestational age, Apgar scores, pH, ultrasound and MRI biomarkers, seizures onset, EEG pattern, and seizure duration were the most referred predictors in the literature. Our study proposes a decision-tree approach based on clinical risk factors for abnormal outcomes in newborns with the neurological syndrome to assist in neonatal encephalopathy prognosis as a complementary tool to the acknowledged scoring systems. We retrospectively studied 188 newborns with associated encephalopathy and seizures in the perinatal period. Etiology and abnormal outcomes were assessed through correlations with the risk factors. We computed mean, median, odds ratios values for birth weight, gestational age, 1-min Apgar Score, 5-min Apgar score, seizures onset, and seizures duration monitoring, applying standard statistical methods first. Subsequently, CART (classification and regression trees) and cluster analysis were employed, further adjusting the medians. Out of 188 cases, 84 were associated to abnormal outcomes. The hierarchy on etiology frequencies was dominated by cerebrovascular impairments, metabolic anomalies, and infections. Both preterms and full-terms at risk were bundled in specific categories defined as high-risk 75–100%, intermediate risk 52.9%, and low risk 0–25% after CART algorithm implementation. Cluster analysis illustrated the median values, profiling at a glance the preterm model in high-risk groups and a full-term model in the inter-mediate-risk category. Our study illustrates that, in addition to standard statistics methodologies, decision-tree approaches could provide a first-step tool for the prognosis of the abnormal outcome in newborns with encephalopathy.

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Brain Injury in Preterm Infants

Cited by 3 publications

References 82 publications

Definition, Epidemiology, and Etiological Factors of Cerebral Palsy

Definition, Epidemiology, and Etiological Factors of Cerebral Palsy

The Value of Routine Cranial Ultrasound in Preterm Neonates less than 37 weeks: A Prospective Analytical Study

A Decision-Tree Approach to Assist in Forecasting the Outcomes of the Neonatal Brain Injury

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