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Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants
- Source :
- The Journal of pediatrics. 195
- Publication Year :
- 2017
-
Abstract
- OBJECTIVES: To describe the frequency and findings of cranial imaging in moderately preterm (MPT) infants (born at 29 0/7–33 6/7 weeks of gestation) across centers, and to examine the association between abnormal imaging and clinical characteristics. STUDY DESIGN: We used data from the Neonatal Research Network MPT Registry, including the most severe early (≤28 days) and late (>28 days) cranial imaging. Stepwise logistic regression and CART analysis were performed after adjustment for gestational age (GA), antenatal steroids and center. RESULTS: Among 7,021 infants, 4,184 (60%) underwent cranial imaging. These infants had lower GAs and birth weights and higher rates of birth weight small-for-gestation, outborn birth, cesarean delivery; neonatal resuscitation and treatment with surfactant, compared with those without imaging (P < .0001). Imaging abnormalities noted in 15% of the infants included any intracranial hemorrhage (13.2%), grades 3–4 intracranial hemorrhage (1.7%), cystic periventricular leukomalacia (2.6%) and ventriculomegaly (6.6%). Histological chorioamnionitis [OR 1.47; 95% C.I.:1.19–1.83], GA [0.95; 95% C.I.: 0.94–0.97], antenatal steroids [OR 0.55; 95% C.I.: 0.41–0.74] and cesarean delivery [OR 0.66; 95% C.I.: 0.53–0.81] were associated with abnormal imaging. The center with the highest rate of cranial imaging, compared with the lowest, had a higher risk of abnormal imaging [OR 2.08; 95% CI: 1.10–3.92]. On the CART model, cesarean delivery, center, antenatal steroids and chorioamnionitis, in that order, predicted abnormal imaging. CONCLUSIONS: Among the 60% of MPT infants with cranial imaging, 15% had intracranial hemorrhage, cystic periventricular leukomalacia or late ventriculomegaly. Further correlation of imaging and long-term neurodevelopmental outcomes in MPT infants is needed.
- Subjects :
- Adult
medicine.medical_specialty
Leukomalacia, Periventricular
Resuscitation
Gestational Age
Antenatal steroid
Article
03 medical and health sciences
Young Adult
0302 clinical medicine
Neonatal Screening
Pregnancy
Risk Factors
030225 pediatrics
medicine
Humans
Prospective Studies
Registries
Obstetrics
business.industry
Cesarean Section
Infant, Newborn
Gestational age
Brain
Infant
Stepwise regression
medicine.disease
Cystic Periventricular Leukomalacia
Chorioamnionitis
Logistic Models
Pediatrics, Perinatology and Child Health
Infant, Small for Gestational Age
Gestation
Small for gestational age
Female
business
Intracranial Hemorrhages
030217 neurology & neurosurgery
Neonatal resuscitation
Infant, Premature
Ventriculomegaly
Hydrocephalus
Subjects
Details
- ISSN :
- 10976833
- Volume :
- 195
- Database :
- OpenAIRE
- Journal :
- The Journal of pediatrics
- Accession number :
- edsair.doi.dedup.....1127fae1bdadbcf235fa4b4e36c89d08