Maternal Antibiotics and Decreased Periventricular Leukomalacia in Very Low-Birth-Weight Infants

Paul, David A.; Coleman, Mae M.; Leef, Kathleen H; Tuttle, Deborah; Stefano, John L.

doi:10.1001/archpedi.157.2.145

Cited by 13 publications

(4 citation statements)

References 32 publications

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“…Recently, maternal antibiotic administration before delivery has been associated with a decreased risk of cPVL (33) suggesting that changes in management have diminished the adverse consequences of HCA. Besides the obstetric treatment of the high-risk pregnancies, the management practices of children born very preterm with cardiorespiratory failure are likely to influence the outcome (34).…”

Section: Discussionmentioning

confidence: 99%

Population Cohort Associating Chorioamnionitis, Cord Inflammatory Cytokines and Neurologic Outcome in Very Preterm, Extremely Low Birth Weight Infants

et al. 2006

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Intrauterine inflammation may relate to neurologic disability among preterm children. We investigated the relationship between chorioamnionitis, cord serum cytokines, and neurologic outcome. Sixty-one consecutively born very preterm extremely low birth weight (ELBW) infants were prospectively enrolled. Histologic inflammation in placenta and umbilical cord and vascular pathology were evaluated. Cord sera were analyzed for five proinflammatory cytokines. Serial brain ultrasound and magnetic resonance imaging were performed for evaluation of intraventricular hemorrhage (IVH grade I-III) and white matter damage (WMD: cystic periventricular leukomalacia or IVH grade IV). Neurologic and neurocognitive outcomes were assessed at the corrected age of 2 y. The incidences of HCA, WMD, and abnormal neurologic outcome were 48%, 13% and 19%, respectively. HCA or high IL-6 in cord serum predicted spontaneous preterm labor with high accuracy. HCA increased the risk of IVH grade II-III. In HCA, without either clinical chorioamnionitis or histologic placental perfusion defect, the children had a low risk of WMD (0%) and a low risk of abnormal neurologic outcome (6%). In HCA, the concentration of IL-6 in cord serum was lower in children with abnormal neurologic outcome than in children with normal neurologic outcome. In HCA and placental perfusion defect (compound defect) the risk of abnormal neurologic outcome was high. Compound placental defect and WMD additively predicted abnormal neurologic outcome. We propose that HCA together with other insults (placental perfusion defect or maternal systemic infection) increases the risk of poor neurologic outcome in very preterm ELBW infants. (Pediatr Res 59: 478-483, 2006)

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Section: Discussionmentioning

confidence: 99%

Population Cohort Associating Chorioamnionitis, Cord Inflammatory Cytokines and Neurologic Outcome in Very Preterm, Extremely Low Birth Weight Infants

et al. 2006

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“…It has been shown that prematurity can be significantly reduced by use of antibiotics in early pregnancy [46]. Although there is some evidence of antibiotic use before premature delivery preventing periventricular leucomalacia, this has not been borne out by controlled trials [28,57].…”

Section: Preventionmentioning

confidence: 99%

Periventricular leucomalacia: a review

Blumenthal

2004

Eur J Pediatr

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“…Therefore, maternal use of antibiotics can decrease the incidence of neonatal PVL. 20 Hypocarbia is associated with PVL because the time-averaged CO 2 index is larger and the timeaveraged PaCO 2 is lower in infants with PVL compared with normal infants. 21 The results of this study also confirmed such conditions.…”

Section: Discussionmentioning

confidence: 99%

Periventricular Leukomalacia in Premature Infants in Mainland China

Liu¹,

Li²,

Qin³

et al. 2008

Amer J Perinatol

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Periventricular leukomalacia (PVL) in premature infants is a major cause of mortality and disability. However, while China is the largest developing country, there is an absence of data concerning PVL. This study was carried out in order to explore the incidence rate and analyze the high-risk factors of PVL in premature infants, and to suggest a working protocol for the prevention of PVL in newborns at risk. The cohort prospective study included 921 premature infants < 37 weeks' gestation from January 2004 to July 2007. The study group was comprised of 271 premature infants with an ultrasound diagnosis of PVL and the control group was comprised of 650 premature infants who were submitted to the same evaluation protocol but did not show any echographic signs of PVL. The results showed that the incidence rate of PVL was 29.4% in China. High-degree PVL accounted for < 12% and > 88% of PVL was low-degree. The incidence rate was much higher when premature infants were accompanied by the following complications: low gestational age, low birth weight, prolonged rupture of membranes, chorionitis, mechanical ventilation, periventricular-ventricular hemorrhage, hypocapnia, and hyperlactacidemia. Severe complications that occur in premature infants also significantly increase the incidence of PVL. Antenatal corticosteroids can significantly decrease the incidence rate of PVL. This investigation provided a theoretical reference for the prevention of premature PVL.

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Maternal Antibiotics and Decreased Periventricular Leukomalacia in Very Low-Birth-Weight Infants

Abstract: In our population of very low-birth-weight infants, maternal antibiotics were associated with a decreased risk of cystic PVL. Maternal antibiotics do not change the risk of mortality, sepsis, or severe IVH.

Cited by 13 publications

References 32 publications

Population Cohort Associating Chorioamnionitis, Cord Inflammatory Cytokines and Neurologic Outcome in Very Preterm, Extremely Low Birth Weight Infants

Population Cohort Associating Chorioamnionitis, Cord Inflammatory Cytokines and Neurologic Outcome in Very Preterm, Extremely Low Birth Weight Infants

Periventricular leucomalacia: a review

Periventricular Leukomalacia in Premature Infants in Mainland China

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