Neonatal Medicine (May 2020)

The Risk Factors of Periventricular Leukomalacia among Very Low Birth Weight Infants

  • Hyun A Park,
  • Jong Hee Hwang

DOI
https://doi.org/10.5385/nm.2020.27.2.51
Journal volume & issue
Vol. 27, no. 2
pp. 51 – 56

Abstract

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Purpose Periventricular leukomalacia (PVL) is an important morbidity in preterm infants. Its reported prevalence in very low birth weight (VLBW) infants is 3% to 15% in VLBW infants. PVL develop seizure disorder, intellectual disability, visual problem, and cerebral palsy. This study was done to describe the risk factors of PVL in VLBW infants. Methods Medical records of 172 VLBW infants at Inje University Ilsan Paik Hospital neonatal intensive care unit were reviewed retrospectively from January 2010 to December 2014. Patients were divided into the non­PVL group (n=155) and the PVL group (n=17). The PVL group included both cystic and non­cystic forms. Demographic findings and factors associated with PVL were compared between these groups. Results The incidence of non­cystic and cystic PVL was 9.8%. The mean gestational age was significantly lower in the PVL group. The mean birth weight was not significantly different between the groups. The incidences of premature rupture of membrane and pregnancy induced hypertension were not significantly different between the two groups. The number of histologic chorioamnionitis was significantly higher in the PVL group (P<0.05). Other conditions such as respiratory distress syndrome, patent ductus arteriosus, early­onset sepsis, and hypotension were not significantly different between the two groups. The incidence of intravascular hemorrhage (IVH) (grade ≥3) was more significant in the PVL group (P<0.05). Multiple logistic regression analysis indicated that histologic chorioamnionitis (odds ratio [OR], 6.3; 95% confidence interval [CI], 1.1 to 36.3) and IVH (grade ≥3) (OR, 16.9; 95% CI, 1.9 to 153.1) were significant risk factors of PVL. Conclusion Histologic chorioamnionitis and IVH (grade ≥3) increase the risk of PVL in VLBW infants. Strategies to prevent these conditions could attenuate the incidence of PVL.

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