Cranial ultrasound findings in late preterm infants and correlation with perinatal risk factors

Italian Journal of Pediatrics

Fabio Mosca¹  Fabio Triulzi²  Dario Consonni³  Alessandra Ometto¹  Michela Groppo¹  Ida Sirgiovanni¹  Silvia Pisoni¹  Francesca Dessimone¹  Pietro Farè¹  Laura Bassi¹  Agnese De Carli¹  Luca Antonio Ramenghi⁴  Monica Fumagalli¹ 

[1] NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy;Division of Neuroradiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy;Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Department of Occupational and Environmental Health, Unit of Epidemiology, Milan, Italy;Neonatal Intensive Care Unit, Giannina Gaslini Paediatric Institute, IGG IRCCS, Genoa, Italy

关键词: Perinatal risk factors;    Brain injury;    Cranial ultrasound;    Late preterm infant;   

Others  :  1232905
DOI  :  10.1186/s13052-015-0172-0

 received in 2015-05-27, accepted in 2015-09-11,  发布年份 2015

【 摘 要 】

Background

Late preterm infants are the most represented premature babies. They are exposed to a wide spectrum of brain lesions which are often clinically silent, supporting a possible role of cerebral ultrasound screening. Aim of the study is to describe the pattern of cranial ultrasound abnormalities in late preterm infants and to define the need for cranial ultrasound according to perinatal risk factors.

Methods

A hospital-based cranial ultrasound screening was carried out by performing two scans (at 1 and 5 weeks). Unfavorable cranial ultrasound at 5 weeks was defined as either persistent periventricular hyperechogenicity or severe abnormalities.

Results

One thousand one hundred seventy-two infants were included. Periventricular hyperechogenicity and severe abnormalities were observed in, respectively, 19.6 % and 1 % of late preterms at birth versus 1.8 % and 1.4 % at 5 weeks. Periventricular hyperechogenicity resolved in 91.3 %. At the univariate analysis gestational age (OR 0.5, 95 % CI 0.32-0.77), Apgar score <5 at 5’ (OR 15.3, 1.35-173) and comorbidities (OR 4.62, 2.39-8.98) predicted unfavorable ultrasound at 5 weeks. At the multivariate analysis the accuracy in predicting unfavorable ultrasound, estimated by combined gestational age/Apgar/comorbidities ROC curve, was fair (AUC 74.6) and increased to excellent (AUC 89.4) when ultrasound at birth was included.

Conclusion

Gestational age and comorbitidies are the most important risk factors for detecting brain lesions. The combination of being born at 34 weeks and developing RDS represents the strongest indication to perform a cranial ultrasound. Differently from other studies, twin pregnancy doesn’t represent a risk factor.

【 授权许可】

   
2015 Fumagalli et al.

【 图 表 】

Fig. 1.

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