caa a22 4500 475784383 CHVBK 20180406123654.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/PL00008403 doi (NATIONALLICENCE)springer-10.1007/PL00008403 Risk factors and determinants of neurodevelopmental outcome in cystic periventricular leucomalacia [Elektronische Daten] [Bernhard Resch, Esther Vollaard, Ute Maurer, Josef Haas, Helfried Rosegger, Wilhelm Müller] The aim of the study was to determine risk factors for the development of cystic periventricular leucomalacia (PVL) and to correlate ultrasound findings with neurodevelopmental outcome. By means of a retrospective case-control study (matched for gestational age, birth weight, sex, and year of birth) and a cohort analysis of all preterm infants with cystic PVL documented by ultrasound scans hospitalised at a local tertiary care centre between 1988 and 1998, 98 preterm infants with a gestational age ranging from 26 to 35 weeks were diagnosed as having cystic PVL. The mean day of diagnosis of periventricular echodensities was 3 ± 2 days (range 1-11 days), and of cystic PVL 21 ± 8 days (range 2-47 days). Of 79 infants (1988-1997) eligible for neurodevelopmental follow-up (91%), hemi-, di-, or tetraplegia was diagnosed in 61 (77%), normal mental outcome in 22 (28%), associated visual disorders in 41 (52%) and seizure disorders in 12 (15%) infants. Significant risk factors associated with the development of cystic PVL were premature rupture of membranes, chorioamnionitis, and hyperbilirubinaemia (odds ratios 4.665, 6.026, and 2.460 respectively). Subgroup analysis according to gestational age (26-28, 29-32, 33-35 weeks) revealed similar results despite spontaneous labour (26-28 weeks; odds ratio 4.808) and pre-eclampsia (33-35 weeks; odds ratio 3.517). Multiple pregnancy was associated with a twofold increased risk (odds ratio 2.075). The white matter damage probably accounted for the significantly higher prevalence of apnoeas (P < 0.001) and neonatal seizures (P < 0.001). Cysts located bilateral or parieto-occipital were associated with a higher risk of cerebral palsy (odds ratios 6.933 and 4.327 respectively). Solely anterior located cysts were associated with normal neurological outcome. Increasing size of the cysts was associated with increasing risk of cerebral palsy with a cut-off value of 10 mm (odds ratio 3.300 and above) and all infants with cysts of more than 20 mm diameter had cerebral palsy. Conclusion The high prevalence of premature rupture of the membranes and chorioamnionitis further supports the role of intra-uterine infection in the pathogenesis of periventricular leucomalacia. The overall prognosis of cystic periventricular leucomalacia is poor. Springer-Verlag Berlin Heidelberg, 2000 Key words Cystic periventricular leucomalacia nationallicence Prematurity nationallicence Risk factors nationallicence Ultrasonography nationallicence Neurodevelopmental outcome nationallicence Resch Bernhard Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut Vollaard Esther University Hospital Groningen, Groningen, The Netherlands, NL aut Maurer Ute Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut Haas Josef Department of Gynaecology and Obstetrics, University Hospital, Graz, Austria, AT aut Rosegger Helfried Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut Müller Wilhelm Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut https://doi.org/10.1007/PL00008403 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/PL00008403 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Resch Bernhard Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut NATIONALLICENCE 700 1- Vollaard Esther University Hospital Groningen, Groningen, The Netherlands, NL aut NATIONALLICENCE 700 1- Maurer Ute Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut NATIONALLICENCE 700 1- Haas Josef Department of Gynaecology and Obstetrics, University Hospital, Graz, Austria, AT aut NATIONALLICENCE 700 1- Rosegger Helfried Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut NATIONALLICENCE 700 1- Müller Wilhelm Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria e-mail: bernhard.resch@kfunigraz.ac.at Tel.: +43-316-3852605; Fax: +43-316-3852678, AT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer