Department of Neonatal-Perinatal Medicine, Dalhousie University and the IWK Health Centre, Halifax, NS, Canada.
Department of Obstetrics and Gynaecology, Dalhousie University and the IWK Health Centre, Halifax, NS, Canada.
J Perinatol. 2019 Feb;39(2):269-277. doi: 10.1038/s41372-018-0294-5. Epub 2018 Dec 14.
To identify the temporal trends, risk factors and outcomes of cystic white matter injury (WMI) detected by ultrasound in a population-based cohort of very preterm infants (VPI) with a minimal risk of selection bias.
All live-born VPIs between 22 and < 31 weeks gestational age born in Nova Scotia, Canada from 1993 to 2013.
Cystic WMI was identified in 87 (7%) out of 1184 eligible infants. The gestational age and mortality adjusted prevalence of cystic WMI decreased over time (p = 0.04). In multivariable analysis, chorioamnionitis, antenatal steroids, admission hypothermia, ventilator support, inotropes, and non-Coagulase-negative Staphylococcal and fungal infections were independently associated with cystic WMI. Cerebral palsy was the most common disability in the survivors, however, half of the survivors had none or mild disability.
This cohort study demonstrated a decreasing trend in the incidence of cystic WMI and reported population-based neurological outcomes with cystic WMI, which is important for health-care planning and parental counseling.
在一个基于人群的极低出生体重儿（VLBWI）队列中，通过超声检测囊性脑白质损伤（WMI），以确定其时间趋势、风险因素和结局，该队列中存在最小的选择偏倚风险。
1993 年至 2013 年间，在加拿大新斯科舍省出生的所有胎龄为 22 至＜31 周的活产 VLBWI。
在 1184 名符合条件的婴儿中，有 87 名（7%）患有囊性 WMI。囊性 WMI 的胎龄和死亡率调整后患病率随时间推移而降低（p=0.04）。多变量分析表明，绒毛膜羊膜炎、产前类固醇、入院低体温、呼吸机支持、正性肌力药、凝固酶阴性葡萄球菌和真菌感染与囊性 WMI 独立相关。在幸存者中，脑瘫是最常见的残疾，但一半的幸存者没有或只有轻度残疾。
这项队列研究表明囊性 WMI 的发病率呈下降趋势，并报告了囊性 WMI 的基于人群的神经结局，这对于医疗保健规划和家长咨询很重要。
