Chasco Yrigoyen A, Pallás Alonso C R, Miralles Molina M, Medina López M C, Simón de las Heras R, Rodríguez-Giménez C
Servicio de Neonatología, Hospital 12 de Octubre, Madrid.
An Esp Pediatr. 1997 May;46(5):471-6.
The objective of this study was to know the incidence of periventricular leukomalacia and persistent periventricular echodensities in neonates with a birth weight < 1,500 g and to correlate cranial ultrasound findings with the developmental outcome of these babies at 18 months of corrected age.
We performed a cohort study of 319 newborns weighing 1500 g or less who were admitted to the Neonatal Intensive Care Unit of "12 de Octubre" Hospital between July 1990 and April 1994. Scans were performed while they were hospitalized and 183 surviving infants were followed up to 18 months of corrected age. Relative risks (rr) and 95% confidence intervals (95% CI) were calculated for sequelae according to neonatal cranial ultrasound abnormalities. Ninety-six infants with normal scans were considered as the control group. Persistent periventricular echodensities were classified as mild, moderate or severe.
The incidence of periventricular leukomalacia was 3% (10/319) and of persistent periventricular echodensites was 11.2% (36/319). The percentage of sequelae was 5% for control infants, 15.6% (rr = 3, CI 95% = 0.94-8.8) for persistent periventricular echodensities, independent of its severity, 50% (rr = 9.7, CI 95% = 2.6-35) for moderate persistent periventricular echodensities and 78% (rr = 15.6, CI 95% = 6-38) for periventricular leukomalacia.
Periventricular leukomalacia multiplies the number of sequelae by 15. Persistent periventricular echodensities, independent of its severity, does not multiply the number of sequelae significantly. However, moderate persistent periventricular echodensities multiply the number of sequelae by 9.
本研究的目的是了解出生体重<1500g的新生儿脑室周围白质软化症和持续性脑室周围回声增强的发生率，并将头颅超声检查结果与这些婴儿在矫正年龄18个月时的发育结局相关联。
我们对1990年7月至1994年4月期间入住“10月12日”医院新生儿重症监护病房的319例体重1500g或以下的新生儿进行了队列研究。在他们住院期间进行扫描，对183例存活婴儿随访至矫正年龄18个月。根据新生儿头颅超声异常情况计算后遗症的相对风险（rr）和95%置信区间（95%CI）。96例扫描正常的婴儿被视为对照组。持续性脑室周围回声增强分为轻度、中度或重度。
脑室周围白质软化症的发生率为3%（10/319），持续性脑室周围回声增强的发生率为11.2%（36/319）。对照组婴儿的后遗症发生率为5%，持续性脑室周围回声增强的后遗症发生率为15.6%（rr = 3，CI 95% = 0.94 - 8.8），与严重程度无关；中度持续性脑室周围回声增强的后遗症发生率为50%（rr = 9.7，CI 95% = 2.6 - 35）；脑室周围白质软化症的后遗症发生率为78%（rr = 15.6，CI 95% = 6 - 38）。
脑室周围白质软化症使后遗症数量增加15倍。持续性脑室周围回声增强，无论其严重程度如何，均不会显著增加后遗症数量。然而，中度持续性脑室周围回声增强使后遗症数量增加9倍。
