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 - https://www.scopus.com/pages/publications/85008425592
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 -