Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age

Subrata Sarkar, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI. Electronic address: subratas@med.umich.edu.
Seetha Shankaran, Department of Pediatrics, Wayne State University, Detroit, MI.
John Barks, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI.
Barbara T. Do, Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.
Abbot R. Laptook, Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI.
Abhik Das, Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD.
Namasivayam Ambalavanan, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.Follow
Krisa P. Van Meurs, Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
Edward F. Bell, Department of Pediatrics, University of Iowa, Iowa City, IA.
Pablo J. Sanchez, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
Susan R. Hintz, Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
Myra H. Wyckoff, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
Barbara J. Stoll, Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA.
Waldemar A. Carlo, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.

Document Type

Article

Publication Title

The Journal of pediatrics

Abstract

OBJECTIVE: To determine the outcome of preterm infants whose cystic periventricular leukomalacia "disappeared" on serial screening cranial imaging studies. STUDY DESIGN: Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging studies at least twice, the most abnormal study at <28 days of age and another closest to 36 weeks, were reviewed. The outcome of late death (after 36 weeks postmenstrual age) or neurodevelopmental impairment (NDI) in surviving infants at 18-26 months corrected age was compared between the infants with no cystic periventricular leukomalacia on both studies and cystic periventricular leukomalacia that disappeared (cystic periventricular leukomalacia at <28 days but not at 36 weeks), persisted (cystic periventricular leukomalacia on both studies), or appeared late (cystic periventricular leukomalacia only at 36 weeks). Predictors of NDI were evaluated by logistic regression. RESULTS: Of 7063 eligible infants, 433 (6.1%) had cystic periventricular leukomalacia. Among the 433 infants with cystic periventricular leukomalacia, cystic periventricular leukomalacia disappeared in 76 (18%), persisted in 87 (20%), and 270 (62%) had late cystic periventricular leukomalacia. Loss to follow-up ranged between 3% and 13%. Death or NDI was more common in infants with disappeared cystic periventricular leukomalacia compared with those with no cystic periventricular leukomalacia (38 of 72 [53%] vs 1776 of 6376 [28%]; OR [95% CI] 2.8 [1.8-4.6]). Disappeared, persistent, and late cystic periventricular leukomalacia were all also independently associated with NDI (OR 1.17, 1.21, and 1.16, respectively). CONCLUSIONS: Infants with "disappeared" cystic periventricular leukomalacia are at increased risk of adverse outcome similar to infants with persistent or late cystic periventricular leukomalacia.

First Page

59

Last Page

65.e3

DOI

10.1016/j.jpeds.2017.12.010

Publication Date

4-1-2018

Identifier

29398046 (pubmed); NIHMS1009193 (mid); PMC6407628 (pmc); 10.1016/j.jpeds.2017.12.010 (doi); S0022-3476(17)31632-3 (pii)

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