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J Pediatr ; 237: 197-205.e4, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34090894

RESUMEN

OBJECTIVE: To examine the association between neonatal cranial ultrasound (CUS) abnormalities among infants born extremely preterm and neurodevelopmental outcomes at 10 years of age. STUDY DESIGN: In a multicenter birth cohort of infants born at <28 weeks of gestation, 889 of 1198 survivors were evaluated for neurologic, cognitive, and behavioral outcomes at 10 years of age. Sonographic markers of white matter damage (WMD) included echolucencies in the brain parenchyma and moderate to severe ventricular enlargement. Neonatal CUS findings were classified as intraventricular hemorrhage (IVH) without WMD, IVH with WMD, WMD without IVH, and neither IVH nor WMD. RESULTS: WMD without IVH was associated with an increased risk of cognitive impairment (OR 3.5, 95% CI 1.7, 7.4), cerebral palsy (OR 14.3, 95% CI 6.5, 31.5), and epilepsy (OR 6.9; 95% CI 2.9, 16.8). Similar associations were found for WMD accompanied by IVH. Isolated IVH was not significantly associated these outcomes. CONCLUSIONS: Among children born extremely preterm, CUS abnormalities, particularly those indicative of WMD, are predictive of neurodevelopmental impairments at 10 years of age. The strongest associations were found with cerebral palsy.


Asunto(s)
Hemorragia Cerebral Intraventricular/complicaciones , Hemorragia Cerebral Intraventricular/diagnóstico por imagen , Enfermedades del Prematuro/diagnóstico por imagen , Leucoencefalopatías/complicaciones , Leucoencefalopatías/diagnóstico por imagen , Trastornos del Neurodesarrollo/epidemiología , Factores de Edad , Hemorragia Cerebral Intraventricular/terapia , Niño , Estudios de Cohortes , Cuidados Críticos , Ecoencefalografía , Femenino , Hospitalización , Humanos , Recien Nacido Extremadamente Prematuro , Recién Nacido , Enfermedades del Prematuro/terapia , Leucoencefalopatías/terapia , Masculino , Trastornos del Neurodesarrollo/diagnóstico , Estados Unidos
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