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The clinical characteristics and neurodevelopmental outcome of preterm infants with persistent periventricular
Mi Hye Bae1, Hyun Ji Jang1, Na Rae Lee2
1Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea.
Insights
Persistent periventricular echogenicity (PVE) in preterm infants is not associated with adverse neurodevelopmental outcomes. This finding suggests that PVE without cystic changes may be a benign indicator in neonates.
Area of Science:
- Neonatal Neurology
- Pediatric Imaging
- Developmental Pediatrics
Background:
- Periventricular echogenicity (PVE) on cranial ultrasonography indicates white matter lesions in neonates.
- Prolonged or persistent PVE, observed beyond two weeks of life, warrants further investigation.
- Understanding the implications of persistent PVE is crucial for assessing neurodevelopmental trajectories in preterm infants.
Purpose of the Study:
- To investigate the clinical characteristics of preterm infants exhibiting persistent PVE beyond two weeks post-birth.
- To determine if persistent PVE is associated with adverse neurodevelopmental outcomes at 12 months corrected age.
- To evaluate the significance of persistent PVE as a potential indicator of neurological compromise.
Main Methods:
- Retrospective review of medical records for preterm infants (< 34 weeks gestation) admitted between 2009-2014.
- Enrolled 28 preterm infants with persistent PVE and 60 matched controls.
- Assessed clinical data and compared neurodevelopmental outcomes using the Bayley Scales of Infant Development-III at 12 months corrected age.
Main Results:
- No significant differences in gestational age or birth weight between persistent PVE and control groups.
- A higher incidence of late sepsis was observed in the persistent PVE group (p=0.001).
- No significant differences in motor, language, or cognitive scores were found between groups at 12 months corrected age.
Conclusions:
- Preterm infants with persistent PVE show similar clinical characteristics and neurodevelopmental outcomes compared to controls.
- Persistent PVE, in the absence of cystic changes, may represent a benign finding.
- Further research can explore the long-term implications and potential underlying causes of persistent PVE.
Purpose:
Periventricular echogenicity (PVE) presents as diffuse echo dense lesions of the periventricular white matter on cranial ultrasonography. Beyond two weeks of life, it is considered as prolonged or persistent PVE. The aim of our study was to investigate the clinical characteristics of preterm infants with persistent PVE beyond 2 weeks after birth and to determine whether these infants had an adverse neurodevelopmental outcome.
Methods:
The medical records of preterm infants who were born at < 34 weeks of gestation and admitted to Pusan National University Hospital between 2009 and 2014 were reviewed. A total of 28 preterm infants with persistent PVE were enrolled. Sixty compatible infants closely matched for gestational age and birth weight to infants with PVE were selected as the control group. Clinical data, including maternal, perinatal and neonatal characteristics, were analyzed. We compared the Bayley Scales of Infant Development-III at 12 months' corrected age.
Results:
The mean gestational age and birth weight were 31 + 3 (range, 29 + 2-33 + 6) weeks and 1523 (range, 911-2210) g, respectively, in the persistent PVE group. In the control group, the mean gestational age was 31 + 4 (range, 29 + 2-33 + 6) weeks and the mean birth weight was 1537 (range, 840-2100) g. There was no significant difference between the persistent PVE group and the control group, except for a significantly higher incidence of late sepsis in the persistent PVE group (p = 0.001). The results of Bayley test at 12 months of corrected age were available for 24 infants in the persistent PVE group and for 26 infants in the control group. A motor score of 86 (range, 78-95) versus 88 (range, 79-100), a language composite score of 88 (range, 78-97) versus 89 (range, 80-105), and a cognitive score of 90 (range, 81-100) versus 92 (range, 85-105) were observed in the persistent PVE group and the control group, respectively. No difference was detected in any scores between the two groups.
Conclusion:
The clinical characteristics and neurodevelopmental outcomes of preterm infants with persistent PVE were not different from those of infants with normal findings. Our study supports the concept that persistent PVE without cystic change may be a benign finding.
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