Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns

Nienke Wagenaar; Vann Chau; Floris Groenendaal; Karina J. Kersbergen; Kenneth J. Poskitt; Ruth E. Grunau; Anne Synnes; Emma G. Duerden; Linda S. de Vries; Steven P. Miller; Manon J N L Benders

doi:10.1016/j.jpeds.2016.11.073

Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns

Nienke Wagenaar, Vann Chau, Floris Groenendaal, Karina J. Kersbergen, Kenneth J. Poskitt, Ruth E. Grunau, Anne Synnes, Emma G. Duerden, Linda S. de Vries, Steven P. Miller, Manon J N L Benders^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: To identify clinical risk factors for punctate white matter lesions (PWML) on early magnetic resonance imaging (MRI) in 2 cohorts of newborns born extremely preterm in different neonatal centers. Study design: A total of 250 newborns born preterm at less than 28 weeks of gestation (mean 26.4 ± 1.1 weeks) with an early MRI were identified from 2 neonatal centers, in Vancouver, Canada (cohort A, n = 100) and Utrecht, the Netherlands (cohort B, n = 150). Cohort A was imaged as part of a prospective research study and cohort B was imaged as part of routine clinical care. PWML were defined as cluster type foci of hyperintensity on T1-weighted imaging and were identified at a mean postmenstrual age of 31.1 (±1.9) weeks. Multivariable analysis was used to identify clinical factors predictive of PWML. Results: Cluster type PWML were found in 47 newborns born extremely preterm (18.8%) and were more common in cohort A (32%) than in cohort B (10%). Newborns in cohort A generally were sicker than those in cohort B. Multivariable analyses revealed that greater birth weight (B = 0.002; P <.02), grade II-III intraventricular hemorrhage (B = 0.83; P <.02), and cohort A (B = 1.34; P <.0001) were independent predictors of PWML. Conclusion: Several risk factors for PWML on early MRI were identified. The interaction among birth weight, intraventricular hemorrhage, and other aspects of postnatal illness as risk factors for PWML warrants further investigation in newborns born extremely preterm and may help to identify modifiable risk factors for PWML.

Original language	English
Pages (from-to)	34–40.e1
Journal	Journal of Pediatrics
Volume	182
DOIs	https://doi.org/10.1016/j.jpeds.2016.11.073
Publication status	Published - Mar 2017

Keywords

Magnetic resonance imaging
Neonate
Premature
White matter injury

Access to Document

10.1016/j.jpeds.2016.11.073

Cite this

Wagenaar, N., Chau, V., Groenendaal, F., Kersbergen, K. J., Poskitt, K. J., Grunau, R. E., Synnes, A., Duerden, E. G., de Vries, L. S., Miller, S. P., & Benders, M. J. N. L. (2017). Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns. Journal of Pediatrics, 182, 34–40.e1. https://doi.org/10.1016/j.jpeds.2016.11.073

@article{7003b52a39064b5996f1743a9ed33f68,

title = "Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns",

abstract = "Objective: To identify clinical risk factors for punctate white matter lesions (PWML) on early magnetic resonance imaging (MRI) in 2 cohorts of newborns born extremely preterm in different neonatal centers. Study design: A total of 250 newborns born preterm at less than 28 weeks of gestation (mean 26.4 ± 1.1 weeks) with an early MRI were identified from 2 neonatal centers, in Vancouver, Canada (cohort A, n = 100) and Utrecht, the Netherlands (cohort B, n = 150). Cohort A was imaged as part of a prospective research study and cohort B was imaged as part of routine clinical care. PWML were defined as cluster type foci of hyperintensity on T1-weighted imaging and were identified at a mean postmenstrual age of 31.1 (±1.9) weeks. Multivariable analysis was used to identify clinical factors predictive of PWML. Results: Cluster type PWML were found in 47 newborns born extremely preterm (18.8%) and were more common in cohort A (32%) than in cohort B (10%). Newborns in cohort A generally were sicker than those in cohort B. Multivariable analyses revealed that greater birth weight (B = 0.002; P <.02), grade II-III intraventricular hemorrhage (B = 0.83; P <.02), and cohort A (B = 1.34; P <.0001) were independent predictors of PWML. Conclusion: Several risk factors for PWML on early MRI were identified. The interaction among birth weight, intraventricular hemorrhage, and other aspects of postnatal illness as risk factors for PWML warrants further investigation in newborns born extremely preterm and may help to identify modifiable risk factors for PWML.",

keywords = "Magnetic resonance imaging, Neonate, Premature, White matter injury",

author = "Nienke Wagenaar and Vann Chau and Floris Groenendaal and Kersbergen, {Karina J.} and Poskitt, {Kenneth J.} and Grunau, {Ruth E.} and Anne Synnes and Duerden, {Emma G.} and {de Vries}, {Linda S.} and Miller, {Steven P.} and Benders, {Manon J N L}",

note = "Funding Information: Supported by the Canadian Institutes of Health Research (MOP 79262 [to S.M.] and MOP 86489 [to R.G]) and the Kids Brain Health Network National Centres of Excellence (to S.M.). R.G. received a Senior Scientist award from the Child and Family Research Institute. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2016 Elsevier Inc.",

year = "2017",

month = mar,

doi = "10.1016/j.jpeds.2016.11.073",

language = "English",

volume = "182",

pages = "34–40.e1",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns

AU - Wagenaar, Nienke

AU - Chau, Vann

AU - Groenendaal, Floris

AU - Kersbergen, Karina J.

AU - Poskitt, Kenneth J.

AU - Grunau, Ruth E.

AU - Synnes, Anne

AU - Duerden, Emma G.

AU - de Vries, Linda S.

AU - Miller, Steven P.

AU - Benders, Manon J N L

N1 - Funding Information: Supported by the Canadian Institutes of Health Research (MOP 79262 [to S.M.] and MOP 86489 [to R.G]) and the Kids Brain Health Network National Centres of Excellence (to S.M.). R.G. received a Senior Scientist award from the Child and Family Research Institute. The authors declare no conflicts of interest. Publisher Copyright: © 2016 Elsevier Inc.

PY - 2017/3

Y1 - 2017/3

N2 - Objective: To identify clinical risk factors for punctate white matter lesions (PWML) on early magnetic resonance imaging (MRI) in 2 cohorts of newborns born extremely preterm in different neonatal centers. Study design: A total of 250 newborns born preterm at less than 28 weeks of gestation (mean 26.4 ± 1.1 weeks) with an early MRI were identified from 2 neonatal centers, in Vancouver, Canada (cohort A, n = 100) and Utrecht, the Netherlands (cohort B, n = 150). Cohort A was imaged as part of a prospective research study and cohort B was imaged as part of routine clinical care. PWML were defined as cluster type foci of hyperintensity on T1-weighted imaging and were identified at a mean postmenstrual age of 31.1 (±1.9) weeks. Multivariable analysis was used to identify clinical factors predictive of PWML. Results: Cluster type PWML were found in 47 newborns born extremely preterm (18.8%) and were more common in cohort A (32%) than in cohort B (10%). Newborns in cohort A generally were sicker than those in cohort B. Multivariable analyses revealed that greater birth weight (B = 0.002; P <.02), grade II-III intraventricular hemorrhage (B = 0.83; P <.02), and cohort A (B = 1.34; P <.0001) were independent predictors of PWML. Conclusion: Several risk factors for PWML on early MRI were identified. The interaction among birth weight, intraventricular hemorrhage, and other aspects of postnatal illness as risk factors for PWML warrants further investigation in newborns born extremely preterm and may help to identify modifiable risk factors for PWML.

AB - Objective: To identify clinical risk factors for punctate white matter lesions (PWML) on early magnetic resonance imaging (MRI) in 2 cohorts of newborns born extremely preterm in different neonatal centers. Study design: A total of 250 newborns born preterm at less than 28 weeks of gestation (mean 26.4 ± 1.1 weeks) with an early MRI were identified from 2 neonatal centers, in Vancouver, Canada (cohort A, n = 100) and Utrecht, the Netherlands (cohort B, n = 150). Cohort A was imaged as part of a prospective research study and cohort B was imaged as part of routine clinical care. PWML were defined as cluster type foci of hyperintensity on T1-weighted imaging and were identified at a mean postmenstrual age of 31.1 (±1.9) weeks. Multivariable analysis was used to identify clinical factors predictive of PWML. Results: Cluster type PWML were found in 47 newborns born extremely preterm (18.8%) and were more common in cohort A (32%) than in cohort B (10%). Newborns in cohort A generally were sicker than those in cohort B. Multivariable analyses revealed that greater birth weight (B = 0.002; P <.02), grade II-III intraventricular hemorrhage (B = 0.83; P <.02), and cohort A (B = 1.34; P <.0001) were independent predictors of PWML. Conclusion: Several risk factors for PWML on early MRI were identified. The interaction among birth weight, intraventricular hemorrhage, and other aspects of postnatal illness as risk factors for PWML warrants further investigation in newborns born extremely preterm and may help to identify modifiable risk factors for PWML.

KW - Magnetic resonance imaging

KW - Neonate

KW - Premature

KW - White matter injury

UR - http://www.scopus.com/inward/record.url?scp=85008425592&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.11.073

DO - 10.1016/j.jpeds.2016.11.073

M3 - Article

C2 - 28063691

AN - SCOPUS:85008425592

SN - 0022-3476

VL - 182

SP - 34–40.e1

JO - Journal of Pediatrics

JF - Journal of Pediatrics

ER -

Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this