Related Experiment Video
Updated: Jul 1, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Cystic periventricular leukomalacia in preterm infants: an analysis of obstetric risk factors
Margit Bauer1, Christa Fast, Josef Haas
1Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria. margit.holzapfel-bauer@meduni-graz.at
Insights
Preterm premature rupture of membranes (PPROM) and prolonged membrane rupture are linked to cystic periventricular leukomalacia (PVL) in preterm infants. These findings suggest a need for careful obstetric management of PPROM to improve neurodevelopmental outcomes.
Area of Science:
- Neonatal Neurology
- Obstetrics
- Perinatal Medicine
Background:
- Cystic periventricular leukomalacia (PVL) is a significant cause of neurological disability in preterm infants.
- Obstetric factors, particularly membrane rupture, are suspected contributors to PVL development.
- Understanding these risk factors is crucial for improving neonatal neurodevelopmental outcomes.
Purpose of the Study:
- To identify obstetric risk factors associated with cystic periventricular leukomalacia (PVL) in preterm infants.
- To determine the specific impact of prolonged rupture of membranes on PVL development.
Main Methods:
- A retrospective case-control study involving 95 preterm infants diagnosed with PVL and 245 matched healthy controls.
- Analysis of 52 antenatal, intrapartum, and neonatal characteristics using univariate methods and logistic regression.
Main Results:
- Preterm premature rupture of membranes (PPROM) and prolonged rupture of membranes were significantly associated with PVL.
- Factors like tocolytic agent use, antibiotics, spontaneous labor onset, and male gender were more frequent in PVL cases.
- Preeclampsia, hypertension, sonographic IUGR, abnormal umbilical artery blood flow, and cesarean section without labor were less frequent in PVL cases. Birth weight became a significant factor in logistic regression.
Conclusions:
- PPROM and prolonged membrane rupture may adversely affect neurodevelopmental outcomes in preterm fetuses.
- Findings suggest potential implications for obstetric management of PPROM, especially beyond 30 weeks of gestation.
- Cesarean section without labor showed a reduced association with PVL diagnosis.
Objective:
To identify obstetric risk factors and to elucidate the effect of prolonged rupture of the membranes on the development of cystic periventricular leukomalacia (PVL) in preterm infants.
Methods:
A retrospective case-control study of 95 preterm infants with the diagnosis of PVL and 245 healthy controls matched for gestational age. A total of 52 antenatal, intrapartum and neonatal characteristics were studied by univariate methods and logistic regression.
Results:
Preterm premature rupture of membranes (PPROM) (odds ratio 2.1 [95% CI 1.3-3.4], P=.003), gestational age at PPROM (P=.025), prolonged rupture of membranes (P<.0001), administration of tocolytic agents (1.8 [1.1-3.0], P=.019) and antibiotics (1.9 [1.2-3.1], P=.008) were associated with PVL. The use of tocolytic agents >24 h (P=.008), prolonged latency between the increase in maternal leukocyte count and birth (P=.034), spontaneous onset of labor (1.8 [1.0-2.9], P=.026), vaginal delivery (1.7 [1.1-2.8], P=.029) and male gender (1.5 [1.0-2.0], P=.04) were found more frequently in PVL cases. Preeclampsia (0.4 [0.1-0.9], P=.034), hypertension at booking (P=.009), sonographic IUGR (P=.020), abnormal blood flow of the umbilical artery (P=.032) and cesarean section without labor (0.5 [0.3-0.8], P=.006) were found less frequently. In logistic regression analysis, prolonged rupture of the membranes (P=.748), preeclampsia (P=.973), the use of antibiotics (P=.617) and beta-sympathomimetic tocolytic agents (P=.563) lost statistical significance, whereas birth weight (P=.036) became significant.
Conclusion:
PPROM and prolonged rupture of the membranes may provoke adverse effects on the neurodevelopmental outcome of the preterm fetus. These findings may have implications on the obstetric management of PPROM beyond 30 weeks of gestation. Cesarean section without labor was less likely associated with the diagnosis of PVL.
