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Periventricular leukomalacia and retinopathy in a term infant born to a mother with asthma

Nina Hagwall1, Eva Engström, Ann Hellström

  • 1Department of Ophthalmology, Ryhov Hospital, Jönköping, Sweden.

Developmental Medicine and Child Neurology
|March 18, 2006
PubMed

Insights

Severe maternal illness during pregnancy, including asthma and cortisone treatment, led to a term infant developing periventricular leukomalacia and retinopathy. These conditions caused significant visual impairment and cognitive challenges, mimicking preterm birth complications.

Area of Science:

  • Neonatal neurology
  • Ophthalmology
  • Maternal-fetal medicine

Background:

  • A term infant born after intrauterine growth retardation (IUGR) experienced severe maternal health issues during pregnancy, including asthma, deep venous thrombosis, and psychosis.
  • Maternal treatment involved terbutaline, budesonide, fenoterolhydrobromide, intravenous/oral cortisone, heparin, diazepam, haloperidol, and levomepromazine.

Observation:

  • The infant presented with periventricular leukomalacia and retinopathy, including total retinal detachment in the left eye and partial detachment in the right eye.
  • Functional sequelae included significant visual impairment (5/60 acuity) and an uneven intellectual profile (Verbal IQ 94, Performance IQ 32 at age 8).
  • Autistic-like behaviors were also noted in the child.

Findings:

  • The combination of intrauterine growth retardation (IUGR) and significant maternal medical interventions, including prolonged cortisone exposure, correlated with severe neurological and ophthalmological pathologies.
  • The infant's neurodevelopmental and visual outcomes were markedly affected, presenting challenges typically associated with preterm infants.

Implications:

  • This case highlights that severe pre- and perinatal risk factors in term infants can precipitate conditions mimicking those seen in preterm neonates.
  • Consideration of maternal health status and treatments is crucial for understanding and managing complex neonatal pathologies.
  • Further research into the long-term effects of maternal illness and medication during pregnancy on infant neurodevelopment and vision is warranted.

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