Risk Factors for Cystic Periventricular Leukomalacia in Very Low Birth Weight Infants.

Park,  Jong Mo; Choi,  Byeong Seon; Sohn,  In A; Seol,  In Joon; Kim,  Chang Ryul; Park,  Hyun Kyung; Lee,  Hyun Ju

doi:2014.21.3.172

Neonatal Med > Volume 21(3); 2014 > Article

Original Article

Neonatal Medicine 2014;21(3):172-178.
DOI: https://doi.org/10.5385/nm.2014.21.3.172 Published online August 30, 2014.

Risk Factors for Cystic Periventricular Leukomalacia in Very Low Birth Weight Infants.

Jong Mo Park, Byeong Seon Choi, In A Sohn, In Joon Seol, Chang Ryul Kim, Hyun Kyung Park, Hyun Ju Lee

Department of Pediatrics, Hanyang University Colleage of Medicine, Seoul, Korea. blesslee77@hanmail.net

Abstract

PURPOSE
In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants.
METHODS
We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records.
RESULTS
Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032).
CONCLUSION
NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.

Key Words: Cystic periventricular leukomalacia; Very low birth weight; Risk factors; Necrotizing enterocolitis; Hypotension; Sepsis