Multivariate analysis of risk of perinatal telencephalic leucoencephalopathy

The hospital and autopsy records of 40 infants who died with perinatal telencephalic leucoencephalopathy (PTL) (hypertrophic astrocytes and amphophilic globules in telencephalic white matter) were compared to those of 76 control infants who had no white matter abnormality. A linear discromination procedure, which takes into account multiple confounding factors, was used to estimate risk ratios. PTL was found more commonly in infants who (a) had bacteria isolated from blood at autopsy, (b) received intravenous glucose and water for more than one day, or (c) received kanamycin or streptomycin. Infants were at reduced risk if they received penicillin, atropine, mercurhydrin or a transfusion of whole blood. It is hypothesized that endotoxin from bacteremia adversely affects developing white matter and that the other risk factors of PTL are markers of, or contributors to, increased risk of gram negative infection. No evidence was found for antibiotic-endotoxin interaction. The factors that are associated with reduced risk of PTL may be markers of, or contributors to reduced risk of gram negative infection.