Neurodevelopmental consequences of preterm punctate white matter lesions: a systematic review

Clara Adriana Maria de Bruijn, Stefano Di Michele, Maria Luisa Tataranno, Luca Antonio Ramenghi, Andrea Rossi, Mariya Malova, Manon Benders, Agnes van den Hoogen, Jeroen Dudink

Research output: Contribution to journalReview articlepeer-review

Abstract

OBJECTIVES: To evaluate punctate white matter lesion (PWML) influence in preterm infants on the long-term neurodevelopmental outcome (NDO).

METHODS: PubMed and EMBASE were searched from January 1, 2000, to May 31, 2021. Studies were included in which PWML in preterm infants on MRI around term-equivalent age (TEA) and NDO at ≥12 months were reported. Study and patient characteristics and NDO on motor, cognitive, and behavioral domains were extracted. The quality of studies was assessed using the Cochrane-approved Quality in Prognosis Studies tool.

RESULTS: This analysis included nine studies with a total of 1655 patients. Mean incidence of isolated PWML was 22.1%. All studies showed a relationship between PWML and motor delay. Two studies found a significant correlation between cognitive and behavioral outcomes and PWML. Number and PWML location are related to severity and impairment types.

LIMITATIONS: PWML were not always separately described from generalized WMI, only studies with imaging around TEA were included, and studies were heterogenic in design and quality.

CONCLUSIONS: PWML is common in preterm infants and predictive of adverse NDO, in particular on motor outcomes and less on cognitive and behavioral outcomes. The type and severity of impairments are related to the number and location of PMWL.

IMPACT: PWML is common in preterm infants and seems predictive of adverse NDO. DWI and SWI MRI sequences are informative because the different patterns suggest a difference in the underlying pathology. The type and severity of impairments are related to the number and location of PMWL. Our review can inform clinicians and parents about the NDO of preterm infants with a diagnosis of PWML. Prospective neuroimaging case-control cohort studies are recommended.

Original languageEnglish
Pages (from-to)1480-1490
Number of pages11
JournalPediatric Research
Volume93
Issue number6
Early online date9 Sept 2022
DOIs
Publication statusPublished - May 2023

Fingerprint

Dive into the research topics of 'Neurodevelopmental consequences of preterm punctate white matter lesions: a systematic review'. Together they form a unique fingerprint.

Cite this