White matter damage and intraventricular hemorrhage in very preterm infants: the EPIPAGE study

Larroque, Béatrice; Marret, Stéphane; Ancel, Pierre‐Yves; Arnaud, Catherine; Marpeau, L.; Supernant, Karine; Pierrat, Véronique; Rozé, Jean‐Christophe; Matis, Jacqueline; Cambonie, Gilles; Burguet, A.; André, M; Kaminski, Monique; Breart, Gérard

doi:10.1067/s0022-3476(03)00417-7

Cited by 190 publications

(120 citation statements)

References 24 publications

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“…White matter damage in extremely or very preterm infants (Ͻ32 completed weeks of gestation) is common, and increased risk is associated with lower gestational age 1 ; white matter microstructural differences in moderate or late preterm infants (32-36 completed weeks of gestation) compared with term infants have also been reported. 2 The abnormality of white matter development associated with low gestational age in preterm infants may extend well beyond infancy, as indicated by observed differences in adolescents born prematurely compared with term-born controls.…”

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confidence: 99%

Gestational Age at Birth and Brain White Matter Development in Term-Born Infants and Children

Glasier

Ramakrishnaiah

et al. 2017

AJNR Am J Neuroradiol

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Gestational Age at Birth and Brain White Matter Development in Term-Born Infants and Children

Glasier

Ramakrishnaiah

et al. 2017

AJNR Am J Neuroradiol

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“…Morbidities include respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), hyperbilirubinemia, feeding difficulties, temperature instability, hypoglycemia and hypocalcaemia [2][3][4][5][6] . Causes of morbidities and mortality in these neonates are immaturity of respiratory, cardiovascular and metabolic function, as well as lower resistance to exogenous bacteria 7 .…”

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Risk Factors for Mortality in Neonates with Birth Weight <1500 gm

et al. 2012

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Background and objective: Neonates with birth weight <1500 gm constitute approximately 4-7% of all live births. Mortality in this group is very high, contributing to as much as 30% of early neonatal death. This study was done to evaluate the morbidities associated with preterm neonates with birth weight < 1500 gm and possible factors determining the death of these babies. Methods: This study was done at Special Care Baby Unit (SCABU), BIRDEM Hospital from January to October 2010. The medical records of neonates with birth weight <1500 gm admitted in SCABU during the study period were retrospectively reviewed. The outcome measure was in-hospital death. Univariate analysis was done to determine the risk factors of mortality. Results: Total 64 babies with birth weight <1500 gm were admitted during this study period. as much as 30% of early neonatal deaths 1 . Morbidities include respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), hyperbilirubinemia, feeding difficulties, temperature instability, hypoglycemia and hypocalcaemia 2-6 . Causes of morbidities and mortality in these neonates are immaturity of respiratory, cardiovascular and metabolic function, as well as lower resistance to exogenous bacteria 7 . Survival of these babies is depended on gestational age, birth weight and disease severity. Well thermal control, monitoring of vital signs, oxygen therapy, maintenance of fluid and electrolyte, special attention to nutritional support and prevention of infection are the cornerstone of management of these neonates 8 . Implementation of intensive care in neonatal unit, use of mechanical ventilation and exogenous surfactant has been reported to improve the outcome of very low birth weight babies but the survival of these neonates varied from hospital to hospital and also from country to country depending on the quality of antenatal, intrapartum, and neonatal care.

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“…Na análise univariada, identificou-se diferença entre os dois grupos para os seguintes achados clínicos: ciclo completo de corticosteroide pré-natal (57% nos casos vs. 80% nos controles; p=0,001; OR: 0,33; IC95% 0,17-0,64); sexo masculino (63% casos vs. 41% controles; p=0,004; OR: 2,45, IC95% 1,3-4,5); nascidos em outro hospital (26% casos vs. 9% controles; p=0,005; OR: 3,3 IC95% 1,4-8,0); Índice de Risco Clínico para Bebês acima de 5 (24% nos casos vs. 12% nos controles; p=0,029; OR: 2,4 IC95% 1,1-5,6); intubação na sala de parto (47% casos vs. 27% controles; p=0,007; OR: 2,38; IC95%: 1,3-4,5); e sepse neonatal (34% nos casos vs. 20% nos controlos; p=0,039; OR: 2,1 95% CI 1,03-4,1). Após a regressão logística, as diferenças foram mantidas apenas para o corticosteróide antenatal (p=0,005; OR 0,34, IC 95% 0,16-0,72) e sexo masculino (p=0,002; OR 2,9, IC95% 1, [4][5]8). Um déficit grave de neurodesenvolvimento esteve presente em três casos (3,5%) e um controle (1,2%).…”

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“…Recent multicenter epidemiological studies reported an incidence rate of IVH of 25-30% for very low birth weight infants and even higher for extreme low birth weight infant [4,5]. The described rate for low-grade IVH (grades I-II) is 11% and for severe IVH (grades III-IV) is 3-5% [4,6,7].…”

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confidence: 99%

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Peixoto

Amaral

Resende

et al. 2018

Sci Med

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AIMS: To evaluate the impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in preterm infants at 24 months of age. METHODS: We conducted a retrospective case-control study of infants with gestational age less than 34 weeks, admitted to a Neonatal Intensive Care Unit between January/2006 and December/2015. Cases were defined as those with low-grade intraventricular hemorrhage (grades I or II), diagnosed by cranial ultrasonography. For each case, a control with the same gestational age but without intraventricular hemorrhage was selected. Follow-up examinations of neurodevelopment were performed at 24 months of age in cases and controls using the Griffiths Mental Development Scale. Cerebral palsy, neurodevelopmental delay (developmental quotient <2 side deviations below the mean), hearing impairment and/or blindness were considered as severe neurodevelopmental impairment. RESULTS: The study included 172 preterm infants: 86 cases and 86 controls. In the univariate analysis, a difference between the two groups was identified for the following clinical findings: antenatal corticosteroid complete cycle (57% in cases vs. 80% in controls; p=0.001; OR: 0.33, 95%CI 0.17-0.64); male gender (63% cases vs. 41% controls; p=0.004; OR: 2.45, 95%CI 1.3-4.5); outborn (26% cases vs. 9% controls; p=0.005; OR: 3.3 95%CI 1.4-8.0); Clinical Risk Index for Babies higher than 5 (24% in cases vs. 12% in controls; p=0.029; OR: 2.4 95%CI 1.1-5.6); intubation in the delivery room (47% cases vs. 27% controls; p=0.007; OR: 2.38 95%CI 1.3-4.5); and neonatal sepsis (34% in cases vs. 20% in controls; p=0.039; OR: 2.1 95%CI 1.03-4.1). After logistic regression, differences were only maintained for antenatal corticosteroid (p=0.005; OR 0.34, 95%CI 0.16-0.72) and male gender (p=0.002; OR 2.9, 95%CI 1.4-5.8). A severe neurodevelopmental deficit was present in three cases (3.5%) and one control (1.2%). No statistically significant differences in outcome were found between cases and controls. CONCLUSIONS: In this sample, preterm infants with low-grade intraventricular hemorrhage diagnosed by cranial ultrasonography had no difference in early neurodevelopmental outcome when compared with controls.KEYWORDS: cerebral intraventricular hemorrhage; preterm infant; neurodevelopmental disorders. RESUMOOBJETIVOS: Avaliar o impacto da hemorragia intraventricular de baixo grau no neurodesenvolvimento de lactentes prematuros aos 24 meses de idade. MÉTODOS: Foi conduzido um estudo de caso-controle retrospectivo em lactentes com idade gestacional inferior a 34 semanas, internados em uma Unidade de Terapia Intensiva Neonatal entre janeiro de 2006 e dezembro de 2015. Os casos foram definidos como aqueles com hemorragia intraventricular de baixo grau (graus I ou II), diagnosticada por ultrassonografia craniana. Para cada caso, foi selecionado um controle com a mesma idade gestacional, mas sem hemorragia intraventricular. A avaliação do neurodesenvolvimento foi realizada aos 24 meses de idade, em casos e controles, com a Escala de Desen...

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White matter damage and intraventricular hemorrhage in very preterm infants: the EPIPAGE study

Cited by 190 publications

References 24 publications

Gestational Age at Birth and Brain White Matter Development in Term-Born Infants and Children

Gestational Age at Birth and Brain White Matter Development in Term-Born Infants and Children

Risk Factors for Mortality in Neonates with Birth Weight <1500 gm

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

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