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J Pediatr. 2018 Apr;195:59-65.e3. doi: 10.1016/j.jpeds.2017.12.010. Epub 2018 Feb 2.

Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age.

Collaborators (322)

Jobe AH13, Caplan MS14, Polin RA15, Keszler M16, Oh W16, Vohr BR16, Hensman AM16, Alksninis B16, Basso KM16, Burke R16, Caskey M16, Johnson K16, Keszler ML16, Knoll AM16, Leach TM16, Little E16, McGowan EC16, Vieira E16, Watson VE16, Ventura S16, Walsh MC17, Fanaroff AA17, Hibbs AM17, Wilson-Costello DE17, Newman NS17, Payne AH17, Siner BS17, Bhola M17, Yalcinkaya G17, Friedman HG17, Truog WE18, Pallotto EK18, Kilbride HW18, Gauldin C18, Holmes A18, Johnson K18, Knutson A18, Schibler K19, Donovan EF19, Grisby C19, Bridges K19, Alexander B19, Fischer EE19, Mincey HL19, Hessling J19, Gratton TL19, Jackson L19, Kirker K19, Muthig G19, Steichen JJ19, Tepe S19, Mersmann MW19, Yolton K19, Goldberg RN20, Cotten CM20, Goldstein RF20, Ashley PL20, Malcolm WF20, Auten KJ20, Fisher KA20, Grimes S20, Gustafson KE20, Lohmeyer MB20, Finkle J20, Laughon MM20, Bose CL20, Bernhardt J20, Bose G20, Warner D20, Wereszczak J20, Carlton DP21, Adams-Chapman I21, Hale EC21, Loggins Y21, Blackwelder AM21, Bottcher DI21, Mackie C21, Higgins RD22, Archer SW22, Sokol GM23, Poindexter BB23, Lemons JA23, Dusick AM23, Papile LA23, Lytle C23, Hines AC23, Minnich HM23, Herron DE23, Smiley L23, Gunn S23, Wilson LD23, Kennedy KA24, Tyson JE24, McDavid GE24, Akpa EG24, Arldt-McAlister J24, Alaniz NI24, Burson K24, Bradt PJ24, Dieterich S24, Dempsey A24, Duncan AF24, Evans PW24, Franco CI24, Garcia C24, Green C24, Harris BF24, Jiminez M24, John J24, Jones PM24, Lillie LM24, Lis AE24, Major-Kincade T24, Martin K24, Martin SC24, Morris BH24, Orekoya PA24, Reddoch S24, Rodgers S24, Siddiki S24, Simmons MC24, Sperry D24, Tate PLP24, Whitely LL24, Wright SL24, Nelin LD25, Jadcherla SR25, Luzader P25, Fortney CA25, Besner GE25, Parikh NA25, Wallace D26, Gantz MG26, Poole WK26, Crawford MM26, Gabrio J26, Hastings BK26, Newman JE26, O'Donnell Auman J26, Huitema CMP26, Zaterka-Baxter KM26, Stevenson DK27, Ball MB27, Adams MM27, Davis AS27, Palmquist AW27, Proud MS27, Bentley B27, Bruno E27, DeAnda ME27, DeBattista AM27, Earhart B27, Huffman LC27, Kohn JG27, Krueger C27, Palmquist AW27, Weiss HE27, Frantz ID 3rd28, Fiascone JM28, MacKinnon BL28, Furey A28, Nylen E28, McGowan EC28, Peralta-Carcelen M29, Collins MV29, Cosby SS29, Biasini FJ29, Johnston KC29, Nelson KG29, Patterson CS29, Phillips VA29, Whitley S29, Devaskar U30, Garg M30, Purdy IB30, Chanlaw T30, Geller R30, Finer NN31, Kaegi D31, Rasmussen MR31, Wozniak PR31, Arnell K31, Demetrio C31, Fuller MG31, Henderson C31, Rich W31, Vaucher YE31, Colaizy TT32, Acarregui MJ32, Brumbaugh JE32, Ellsbury DL32, Widness JA32, Johnson KJ32, Campbell DB32, Eastman DL32, Krutzfield NJ32, Duara S33, Bauer CR33, Everett-Thomas R33, Fajardo-Hiriart S33, Rigaud A33, Calejo M33, Eguaras SMF33, Berkowits MH33, Garcia A33, Pierre H33, Stoerger A33, Watterberg KL34, Papile LA34, Lowe JR34, Dupont T34, Fuller JF34, Ohls RK34, Lacy CB34, Duncan AF34, Montman R34, Schmidt B35, Kirpalani H35, DeMauro SB35, Chaudhary AS35, Abbasi S35, Mancini T35, Cucinotta DM35, Bernbaum JC35, Gerdes M35, Hurt H35, Cook N35, D'Angio CT36, Phelps DL36, Guillet R36, Lakshminrusimha S36, Johnson JB36, Burnell E36, Reubens LJ36, Horihan CA36, Jensen RL36, Kushner E36, Merzbach J36, Myers GJ36, Rowan M36, Wadkins HIM36, Scorsone AM36, Bowman M36, Hunn J36, Guilford S36, Maffett D36, Farooq O36, Prinzing D36, Reynolds AM36, Sacilowski MG36, Williams A36, Wynn K36, Yost K36, Zorn W36, Zwetsch L36, Brion LP37, Broyles RS37, Heyne RJ37, Ipson M37, Salhab WA37, Rosenfeld CR37, Vasil DM37, Chen L37, Guzman A37, Hensley G37, Hickman JF37, Leps MH37, Madison S37, Miller NA37, Morgan JS37, Pavageau L37, Adams SS37, Dooley C37, Heyne ET37, Lee LE37, Madden LA37, Boatman CT37, Faix RG38, Yoder BA38, Osborne KA38, Spencer C38, Weaver-Lewis K38, Baker S38, Bird K38, Burnett J38, Steffen M38, Jensen JJ38, Winter S38, Zanetti K38, O'Shea TM39, Dillard RG39, Washburn LK39, Jackson BG39, Peters NJ39, Chiu K39, Allred DE39, Goldstein DJ39, Halfond R39, Peterson C39, Waldrep EL39, Welch CD39, Morris MW39, Hounshell GW39, Pappas A40, Bara R40, Goldston LA40, Muran G40, Natarajan G40, Christensen M40, Wiggins SA40, White D40, Ehrenkranz RA41, Jacobs H41, Butler CG41, Cervone P41, Gettner P41, Greisman S41, Konstantino M41, Poulsen J41, Romano E41, Taft J41, Williams J41.

Author information

1
Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI. Electronic address: subratas@med.umich.edu.
2
Department of Pediatrics, Wayne State University, Detroit, MI.
3
Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI.
4
Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.
5
Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI.
6
Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD.
7
Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.
8
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
9
Department of Pediatrics, University of Iowa, Iowa City, IA.
10
Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
11
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
12
Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA.
13
University of Cincinnati.
14
University of Chicago, Pritzker School of Medicine.
15
Division of Neonatology, College of Physicians and Surgeons, Columbia University.
16
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.
17
Case Western Reserve University, Rainbow Babies & Children's Hospital.
18
Children's Mercy Hospital, University of Missouri Kansas City School of Medicine.
19
Cincinnati Children's Hospital Medical Center, University Hospital, and Good Samaritan Hospital.
20
Duke University School of Medicine, University Hospital, University of North Carolina, and Duke Regional Hospital.
21
Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, and Emory University Hospital Midtown.
22
Eunice Kennedy Shriver National Institute of Child Health and Human Development.
23
Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services.
24
McGovern Medical School at The University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, and Lyndon Baines Johnson General Hospital/Harris County Hospital District.
25
Nationwide Children's Hospital and the Ohio State University Medical Center.
26
RTI International.
27
Stanford University, Dominican Hospital, El Camino Hospital, and Lucile Packard Children's Hospital.
28
Tufts Medical Center, Floating Hospital for Children.
29
University of Alabama at Birmingham Health System and Children's Hospital of Alabama.
30
University of California - Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, and Olive View Medical Center.
31
University of California, San Diego Medical Center and Sharp Mary Birch Hospital for Women and Newborns.
32
University of Iowa and Mercy Medical Center.
33
University of Miami, Holtz Children's Hospital.
34
University of New Mexico Health Sciences Center.
35
University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, and Children's Hospital of Philadelphia.
36
University of Rochester Medical Center, Golisano Children's Hospital, and the University of Buffalo Women's and Children's Hospital of Buffalo.
37
University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, and Children's Medical Center Dallas.
38
University of Utah Medical Center, Intermountain Medical Center, LDS Hospital, and Primary Children's Medical Center.
39
Wake Forest University, Baptist Medical Center, Forsyth Medical Center, and Brenner Children's Hospital.
40
Wayne State University, Hutzel Women's Hospital and Children's Hospital of Michigan.
41
Yale University, Yale-New Haven Children's Hospital, and Bridgeport Hospital.

Abstract

OBJECTIVE:

To determine the outcome of preterm infants whose cystic periventricular leukomalacia "disappeared" on serial screening cranial imaging studies.

STUDY DESIGN:

Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging studies at least twice, the most abnormal study at <28 days of age and another closest to 36 weeks, were reviewed. The outcome of late death (after 36 weeks postmenstrual age) or neurodevelopmental impairment (NDI) in surviving infants at 18-26 months corrected age was compared between the infants with no cystic periventricular leukomalacia on both studies and cystic periventricular leukomalacia that disappeared (cystic periventricular leukomalacia at <28 days but not at 36 weeks), persisted (cystic periventricular leukomalacia on both studies), or appeared late (cystic periventricular leukomalacia only at 36 weeks). Predictors of NDI were evaluated by logistic regression.

RESULTS:

Of 7063 eligible infants, 433 (6.1%) had cystic periventricular leukomalacia. Among the 433 infants with cystic periventricular leukomalacia, cystic periventricular leukomalacia disappeared in 76 (18%), persisted in 87 (20%), and 270 (62%) had late cystic periventricular leukomalacia. Loss to follow-up ranged between 3% and 13%. Death or NDI was more common in infants with disappeared cystic periventricular leukomalacia compared with those with no cystic periventricular leukomalacia (38 of 72 [53%] vs 1776 of 6376 [28%]; OR [95% CI] 2.8 [1.8-4.6]). Disappeared, persistent, and late cystic periventricular leukomalacia were all also independently associated with NDI (OR 1.17, 1.21, and 1.16, respectively).

CONCLUSIONS:

Infants with "disappeared" cystic periventricular leukomalacia are at increased risk of adverse outcome similar to infants with persistent or late cystic periventricular leukomalacia.

KEYWORDS:

cranial ultrasonography; cystic periventricular leukomalacia; neurodevelopmental impairment

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