Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Dec;124(6):e1153-60.
doi: 10.1542/peds.2009-0953.

Neurodevelopmental outcome of infants with unilateral or bilateral periventricular hemorrhagic infarction

Nathalie L Maitre  1 , Diane D Marshall, Wayne A Price, James C Slaughter, Thomas M O'Shea, Charles Maxfield, Ricki F Goldstein
Affiliations

Neurodevelopmental outcome of infants with unilateral or bilateral periventricular hemorrhagic infarction

Nathalie L Maitre et al. Pediatrics. 2009 Dec.

Abstract

Objective: Periventricular hemorrhagic infarction (PVHI) is a major contributing factor to poor neurodevelopmental outcomes in preterm infants. We hypothesized that surviving infants with unilateral PVHI would have more favorable outcomes than those with bilateral PVHI.

Methods: This was a multicenter, retrospective study of infants who were admitted to 3 NICUs in North Carolina from 1998 to 2004. The clinical course and late neuroimaging studies and neurodevelopmental outcomes of 69 infants who weighed <1500 g and had confirmed PVHI on early cranial ultrasonography were reviewed. A predictive model for Bayley Scales of Infant Development, Second Edition, Mental Developmental Index (MDI) <70 was constructed by using radiologic and clinical variables.

Results: Infants with unilateral PVHI had higher median MDI (82 vs 49) and Psychomotor Developmental Index (53 vs 49) than infants with bilateral PVHI. Infants with unilateral PVHI were less likely to have severe cerebral palsy (adjusted odds ratio: 0.15 [95% confidence interval (CI): 0.05-0.45]) than infants with bilateral PVHI. Infants who had unilateral PVHI and developed periventricular leukomalacia and retinopathy of prematurity that required surgery had an increased probability of having MDI <70 compared with those without these complications (probability of MDI <70: 89% [95% CI: 0.64-1.00] vs 11% [95% CI: 0.01-0.28]).

Conclusions: Infants with unilateral PVHI had better motor and cognitive outcomes than infants with bilateral PVHI. By combining laterality of PVHI, periventricular leukomalacia, and retinopathy of prematurity it is possible to estimate the probability of having an MDI <70, which will assist clinicians when counseling families.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Association between BSID II scores and laterality of PVHI. Shaded line represents the median. Dotted line represents a score of 55. Standardized means for the BSID II are 100.
FIGURE 2
FIGURE 2
Association between BSID II scores and PVL in infants with unilateral PVHI. Shaded line represents the median. Standardized means for the BSID II are 100.
FIGURE 3
FIGURE 3
Prediction of MDI in infants with PVHI.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hack M, Fanaroff AA. Outcomes of children of extremely low birthweight and gestational age in the 1990s. Semin Neonatol. 2000;5(2):89–106. - PubMed
    1. Hack M, Taylor HG. Perinatal brain injury in preterm infants and later neurobehavioral function. JAMA. 2000;284(15):1973–1974. - PubMed
    1. Anderson P, Doyle LW. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289(24):3264–3272. - PubMed
    1. Hamrick SE, Miller SP, Leonard C, et al. Trends in severe brain injury and neurodevelopmental outcome in premature newborn infants: the role of cystic periventricular leukomalacia. J Pediatr. 2004;145(5):593–599. - PubMed
    1. Laptook AR, O’Shea TM, Shankaran S, Bhaskar B, NICHD Neonatal Network Adverse neurodevelopmental outcomes among extremely low birth weight infants with a normal head ultrasound: prevalence and antecedents. Pediatrics. 2005;115(3):673–680. - PubMed

MeSH terms