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. 2020 Nov;46(11):2383-2389.
doi: 10.1111/jog.14473. Epub 2020 Sep 13.

Assessment of risk factors for cystic periventricular leukomalacia

Tomonori Kurimoto  1 , Satoshi Ibara  1 , Masato Kamitomo  2 , Takuya Tokuhisa  3 , Takatsugu Maeda  2 , Yoshinobu Maede  1 , Chie Ishihara  1 , Yoshiki Naito  1 , Eiji Hirakawa  4 , Tsuyoshi Yamamoto  1
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Assessment of risk factors for cystic periventricular leukomalacia

Tomonori Kurimoto et al. J Obstet Gynaecol Res. 2020 Nov.

Abstract

Aim: Periventricular leukomalacia (PVL) is an important cause of cerebral palsy in premature infants, and cystic PVL is the most serious form of the disease. The risk factors for cystic PVL in singleton fetuses at a gestational age of <35 weeks are unclear.

Methods: This study included 2013 singleton birth infants delivered at a gestational age of <35 weeks in Kagoshima City Hospital between 2006 and 2017. The findings for 30 infants with cystic PVL were compared with those for 63 matched control infants by gestational age and birth weight.

Results: The cystic PVL was associated with increased incidence of recurrent late deceleration (L/D) (43.4% vs. 15.9%, P = 0.004) and loss of variability (LOV) (10.0% vs. 0.0%, P = 0.03) in fetal heart rate monitoring and late-onset circulatory dysfunction (LCD) (33.3% vs. 11.1%, P = 0.02). Logistic regression analysis revealed that recurrent L/D (odds ratio [OR] = 3.57, 95% confidence interval [CI]: 1.29-10.15, P = 0.01) and LCD (OR = 3.41, 95% CI: 1.09-11.04, P = 0.03) were risk factors associated with cystic PVL. LOV was not included in the multivariate analysis as there were too few cases in both the cystic PVL and control groups.

Conclusion: Recurrent L/D, LOV and LCD are strongly associated with cystic PVL. In cases of fetal acidosis related to recurrent L/D or loss of variability, cystic PVL may occur.

Keywords: cystic periventricular leukomalacia; late deceleration; late-onset circulatory dysfunction; loss of variability; risk factors.

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References

    1. Back SA. Cerebral white and gray matter injury in newborns: New insights into pathophysiology and management. Clin Perinatol 2014; 41: 1-24.
    1. Khawaja O, Volpe JJ. Pathogenesis of cerebral white matter injury of prematurity. Arch Dis Child Fetal Neonatal Ed 2008; 93: F153-F161.
    1. Volpe JJ, Kinney HC, Jensen FE, Rosenberg PA. The developing oligodendrocyte: Key cellular target in brain injury in the premature infant. Int J Dev Neurosci 2011; 29: 423-440.
    1. Okai T, Ikeda T, Kawarabayashi T et al. Intrapartum management guidelines based on fetal heart rate pattern classification. J Obstet Gynaecol Res 2010; 36: 925-928.
    1. Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr 1983; 103: 273-277.

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