Risk Factors and Prognosis for Periventricular Leukomalacia According to Neuroimage in Preterm Infants

ABSTRACT

PURPOSE: The aim of this study was to determine the risk factors, clinical characteristics and prognosis for the development of periventricular leukomalacia (PVL) in preterm infants according to the extent and site of the PVL. METHODS: The medical records of infants (under 36 weeks of gestational age) delivered from January 1999 to December 2008 were reviewed. Twenty-five preterm infants with were PVL were diagnosed by brain magnetic resonance imaging (MRI) and an addition 50 preterm infants with no brain lesions were enrolled in this study. The perinatal and neonatal risk factors for the development of PVL was determine in these infants. Mental and Psychomotor Developmental Indices (MDI, PDI) were assessed by a clinical psychologist using the Bayley Scales of Infant Development II. We compared the differences of the clinical characteristics and prognosis according to brain MRI findings. RESULTS: Maternal fever, young maternal age, extended oxygen use, hypotension within the first week of birth, use of inotropics within the first week of birth, and respiratory distress syndrome were the risk factors associated with PVL (P<0.05). In the multivariate analysis, maternal fever and extended oxygen use were statistically significant independent risk factors (P<0.05). The mean MDI and PDI scores of the PVL group (74.4+/-27.8 and 58.0+/-17.7) were significantly lower than those of the control group (103.5+/-8.9 and 101.7+/-16.1, P<0.05). CONCLUSION: Maternal fever and extended oxygen use were independent risk factors for PVL. We should pay attention to infants who had the risk factors and follow them up closely by brain imaging study and Bayley Scales of Infant Development II.