Brain MRI Injury Patterns across Gestational Age among Preterm Infants with Perinatal Asphyxia.
Neonatology
; : 1-11, 2024 06 05.
Article
en En
| MEDLINE
| ID: mdl-38838655
ABSTRACT
INTRODUCTION:
Brain injury patterns of preterm infants with perinatal asphyxia (PA) are underreported. We aimed to explore brain magnetic resonance imaging (MRI) findings and associated neurodevelopmental outcomes in these newborns.METHODS:
Retrospective multicenter study included infants with gestational age (GA) 24.036.0 weeks and PA, defined as ≥2 of the following (1) umbilical cord pH ≤7.0, (2) 5-min Apgar score ≤5, and (3) fetal distress or systemic effects of PA. Findings were compared between GA <28.0 (group 1), 28.031.9 (group 2), and 32.036.0 weeks (group 3). Early MRI (<36 weeks postmenstrual age or <10 postnatal days) was categorized according to predominant injury pattern, and MRI around term-equivalent age (TEA, 36.044.0 weeks and ≥10 postnatal days) using the Kidokoro score. Adverse outcomes included death, cerebral palsy, epilepsy, severe hearing/visual impairment, or neurodevelopment <-1 SD at 1824 months corrected age.RESULTS:
One hundred nineteen infants with early MRI (n = 94) and/or MRI around TEA (n = 66) were included. Early MRI showed predominantly hemorrhagic injury in groups 1 (56%) and 2 (45%), and white matter (WM)/watershed injury in group 3 (43%). Around TEA, WM scores were highest in groups 2 and 3. Deep gray matter (DGM) (aOR 15.0, 95% CI 3.8-58.9) and hemorrhagic injury on early MRI (aOR 2.5, 95% CI 1.3-4.6) and Kidokoro WM (aOR 1.3, 95% CI 1.0-1.6) and DGM sub-scores (aOR 4.8, 95% CI 1.1-21.7) around TEA were associated with adverse neurodevelopmental outcomes.CONCLUSION:
The brain injury patterns following PA in preterm infants differ across GA. Particularly DGM abnormalities are associated with adverse neurodevelopmental outcomes.
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Banco de datos:
MEDLINE
Idioma:
En
Año:
2024
Tipo del documento:
Article