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Updated: Jul 4, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
[Leukomalacia and periventricular echogenicity in very low birth weight premature infants]
1Facultad de Medicina, Edificio Ciencias del Cuidado en Salud, Universidad Austral de Chile, Valdivia, Chile. rbarria@uach.cl
Insights
This study found high rates of white matter injuries, persistent periventricular echogenicity (PPVE) and cystic periventricular leukomalacia (c-PVL), in premature infants. Gestational age is a key predictor for c-PVL, while maternal hypertension may offer protection.
Area of Science:
- Neonatal neurology
- Perinatal medicine
- Pediatric neurodevelopment
Background:
- Cystic periventricular leukomalacia (c-PVL) and persistent periventricular echogenicity (PPVE) are significant white matter injuries in premature infants.
- These conditions have a multifactorial etiology and are associated with adverse neurodevelopmental outcomes.
Purpose of the Study:
- To determine the incidence of PPVE and c-PVL in a cohort of very low birth weight premature infants.
- To identify potential perinatal predictors associated with the development of these white matter injuries.
Main Methods:
- A cohort of 164 premature infants (<1,500g, ≤32 weeks gestational age) underwent serial cerebral ultrasounds.
- Diagnosis of PPVE and c-PVL followed Volpe's classification.
- Univariate and multivariate analyses (logistic regression) assessed associations with perinatal factors.
Main Results:
- Incidence rates for PPVE and c-PVL were 13.4% and 23.8%, respectively.
- Infants born before 28 weeks had a significantly higher risk of c-PVL (RR=4.83).
- Lower gestational age (OR=0.5) and maternal hypertension (OR=0.27) were associated with reduced c-PVL risk. Better Apgar scores and male sex decreased PPVE risk.
Conclusions:
- Gestational age is a strong predictor for c-PVL in premature infants.
- Maternal hypertension may have a protective effect against c-PVL, warranting further investigation.
- High incidence of white matter lesions underscores the need for continued research and preventative strategies.
Introduction:
Cystic periventricular leukomalacia (c-PVL) and persistent periventricular echogenicity (PPVE) are white matter injuries of multifactorial etiology, high incidence in premature infants and with harmful effect in neurodevelopment.
Aims:
To determine PPVE and c-PVL incidence, and to assess potential predictors.
Patients And Methods:
Cohort of 164 very low birth weight premature infants (< 1,500 g and with gestational age equal or below 32 weeks), admitted to the Neonatal Care Unit of Hospital Clinico Regional de Valdivia, Chile. Cerebral ultrasound within the first week, at day 15 and day 30 of life was performed, and diagnosis of the lesions was made according Volpe's classification. The association of PPVE and c-PVL with several perinatal factors was evaluated by univariate risk estimation -relative risk (RR), and 95% confidence interval (95% CI)-, and then, multivariate analysis through multiple logistic regression -adjusted odds ratio (OR)--was carried out.
Results:
The incidence of PPVE and c-PVL was 13.4 and 23.8%, respectively. 66.7% of c-PVL cases were observed in infants lower than 28 weeks (RR = 4.83; 95% CI = 2.72-8.58). The risk of c-PVL was lower with gestational age for each additional week (OR = 0.5; 95% CI = 0.38-0.65) and maternal hypertension (OR = 0.27; 95% CI = 0.08-0.87). A significant decrease of PPVE risk was found with better Apgar score after 1 minute and male sex. No association was found with either chorioamnionitis, antenatal corticosteroids nor other perinatal factors.
Conclusions:
This study confirms high incidence of white matter lesions, being gestational age a strong predictor of c-PVL. Studies are needed to clarify maternal hypertension effect on c-PVL development.
