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Updated: Feb 22, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Association between perinatal hypoxic-ischemia and periventricular leukomalacia in preterm infants: A systematic
Jichong Huang1,2, Li Zhang1,2, Bingyao Kang1,2
1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Insights
Hypoxic-ischemia (HI) is linked to periventricular leukomalacia (PVL) in preterm infants. Key risk factors include oligohydramnios, acidemia, low Apgar scores, apnea, respiratory distress, and seizures.
Area of Science:
- Neonatal neurology
- Perinatal medicine
- Pediatric critical care
Background:
- Periventricular leukomalacia (PVL) is a significant cause of neurological disability in preterm infants.
- Hypoxic-ischemia (HI) is a suspected contributor to PVL, but clinical risk factors remain debated.
- Identifying reliable markers for HI-related PVL is crucial for early intervention.
Purpose of the Study:
- To systematically identify and quantify perinatal hypoxic-ischemia (HI)-related risk factors associated with the development of periventricular leukomalacia (PVL).
- To provide evidence-based insights into the clinical predictors of PVL in vulnerable preterm infants.
Main Methods:
- A comprehensive meta-analysis was conducted, searching PubMed, EMBASE, and Cochrane Library databases up to January 2017.
- Pooled odds ratios (ORs) were calculated for 14 potential risk factors using fixed or random effects models.
- Tests for heterogeneity and publication bias were employed to ensure the robustness of the findings.
Main Results:
- Fifteen studies involving 12,851 participants were analyzed.
- Significant risk factors for PVL included maternal oligohydramnios (OR, 1.55), preterm infant acidemia (OR, 1.87), low 1-minute Apgar score (OR, 2.69), low 5-minute Apgar score (OR, 1.89), apnea (OR, 1.76), respiratory distress syndrome (OR, 1.46), and seizures (OR, 4.60).
Conclusions:
- This meta-analysis confirms several perinatal HI-related risk factors significantly associated with PVL in preterm infants.
- Findings highlight the importance of monitoring these factors for potential PVL development.
- Further large-scale prospective studies are recommended to validate these identified risk factors and inform clinical practice.
Background:
Although investigators have implicated hypoxic-ischemia (HI) as a potential cause of periventricular leukomalacia (PVL), the role of clinical risk factors or markers for HI in the development of PVL remains controversial. The aim of this study was to identify perinatal HI-related factors associated with PVL.
Method:
The PubMed, EMBASE, and Cochrane Library databases were searched. The last search was performed on January 2017. Summary effect estimates (pooled odds ratios [ORs]) were calculated for each risk factor using fixed or random effects models with tests for heterogeneity and publication bias.
Results:
Fifteen studies with a total of 12,851 participants were included in this meta-analysis, and 14 potential risk factors were analyzed. The pooled results showed that mothers with oligohydramnios (OR, 1.55; 95% confidence interval [CI], 1.05 to 2.30), preterm infants with acidemia (OR, 1.87; 95% CI, 1.18 to 2.97), 1-minute Apgar score <7 (OR 2.69; 95% CI, 1.13 to 6.41), 5-minute Apgar score <7 (OR, 1.89; 95% CI, 1.39 to 2.56), apnea (OR, 1.76; 95% CI, 1.07 to 2.90), respiratory distress syndrome (OR, 1.46; 95% CI, 1.04 to 2.03), and seizures (OR, 4.60; 95% CI, 2.84 to 7.46) were associated with increased risk of PVL.
Conclusion:
This study identified perinatal HI-related risk factors for the development of PVL in preterm infants. Future large-scale prospective clinical studies are required to validate and extend these findings.
