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Effect of gestational age on cerebral lesions in neonatal encephalopathy.
Binet, Lauren; Debillon, Thierry; Beck, Jonathan; Vilotitch, Antoine; Guellec, Isabelle; Ego, Anne; Chevallier, Marie.
Afiliação
  • Binet L; Neonatal Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.
  • Debillon T; Neonatal Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.
  • Beck J; Université Grenoble Alpes, CNRS, Public Health Department, Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, Grenoble, France.
  • Vilotitch A; Department of Neonatology, Reims University Hospital Alix de Champagne, Reims, France.
  • Guellec I; Univversité Grenoble Alpes, Data Engineering Unit, Public Health Department, Grenoble Alpes University Hospital, Grenoble, France.
  • Ego A; 7 Neonatal Intensive Care Medicine Department, University Hospital Nice Cote d'Azur, Nice, France.
  • Chevallier M; Université Grenoble Alpes, CNRS, Public Health Department, Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, Grenoble, France.
Arch Dis Child Fetal Neonatal Ed ; 109(5): 562-568, 2024 Aug 16.
Article em En | MEDLINE | ID: mdl-38418209
ABSTRACT

OBJECTIVE:

To determine the risk on brain lesions according to gestational age (GA) in neonates with neonatal encephalopathy.

DESIGN:

Secondary analysis of the prospective national French population-based cohort, Long-Term Outcome of NeonataL EncePhALopathy.

SETTING:

French neonatal intensive care units. PATIENTS Neonates with moderate or severe neonatal encephalopathy (NE) born at ≥34 weeks' GA (wGA) between September 2015 and March 2017. MAIN OUTCOME

MEASURES:

The results of MRI performed within the first 12 days were classified in seven injured brain regions basal ganglia and thalami, white matter (WM), cortex, posterior limb internal capsule, corpus callosum, brainstem and cerebellum. A given infant could have several brain structures affected. Risk of brain lesion according to GA was estimated by crude and adjusted ORs (aOR).

RESULTS:

MRI was available for 626 (78.8%) of the 794 included infants with NE. WM lesions predominated in preterm compared with term infants. Compared with 39-40 wGA neonates, those born at 34-35 wGA and 37-38 wGA had greater risk of WM lesions after adjusting for perinatal factors (aOR 4.0, 95% CI (1.5 to 10.7) and ORa 2.0, 95% CI (1.1 to 3.5), respectively).

CONCLUSION:

WM is the main brain structure affected in late-preterm and early-term infants with NE, with fewer WM lesions as GA increases. This finding could help clinicians to estimate prognosis and improve the understanding of the pathophysiology of NE. TRIAL REGISTRATION NUMBER NCT02676063, ClinicalTrials.gov.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Idade Gestacional Limite: Female / Humans / Male / Newborn País/Região como assunto: Europa Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Idade Gestacional Limite: Female / Humans / Male / Newborn País/Região como assunto: Europa Idioma: En Ano de publicação: 2024 Tipo de documento: Article