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

Subrata Sarkar, Seetha Shankaran, John Barks, Barbara T. Do, Abbot R. Laptook, Abhik Das, Namasivayam Ambalavanan, Krisa P. Van Meurs, Edward F. Bell, Pablo J. Sanchez, Susan R. Hintz, Myra H. Wyckoff, Barbara J. Stoll, Waldemar A. Carlo

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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.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Jan 1 2018

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Periventricular Leukomalacia
Premature Infants

Keywords

  • Cranial ultrasonography
  • Cystic periventricular leukomalacia
  • Neurodevelopmental impairment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age. / Sarkar, Subrata; Shankaran, Seetha; Barks, John; Do, Barbara T.; Laptook, Abbot R.; Das, Abhik; Ambalavanan, Namasivayam; Van Meurs, Krisa P.; Bell, Edward F.; Sanchez, Pablo J.; Hintz, Susan R.; Wyckoff, Myra H.; Stoll, Barbara J.; Carlo, Waldemar A.

In: Journal of Pediatrics, 01.01.2018.

Research output: Contribution to journalArticle

Sarkar, S, Shankaran, S, Barks, J, Do, BT, Laptook, AR, Das, A, Ambalavanan, N, Van Meurs, KP, Bell, EF, Sanchez, PJ, Hintz, SR, Wyckoff, MH, Stoll, BJ & Carlo, WA 2018, 'Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age', Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2017.12.010
Sarkar, Subrata ; Shankaran, Seetha ; Barks, John ; Do, Barbara T. ; Laptook, Abbot R. ; Das, Abhik ; Ambalavanan, Namasivayam ; Van Meurs, Krisa P. ; Bell, Edward F. ; Sanchez, Pablo J. ; Hintz, Susan R. ; Wyckoff, Myra H. ; Stoll, Barbara J. ; Carlo, Waldemar A. / Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age. In: Journal of Pediatrics. 2018.
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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.",
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author = "Subrata Sarkar and Seetha Shankaran and John Barks and Do, {Barbara T.} and Laptook, {Abbot R.} and Abhik Das and Namasivayam Ambalavanan and {Van Meurs}, {Krisa P.} and Bell, {Edward F.} and Sanchez, {Pablo J.} and Hintz, {Susan R.} and Wyckoff, {Myra H.} and Stoll, {Barbara J.} and Carlo, {Waldemar A.}",
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AU - Sarkar, Subrata

AU - Shankaran, Seetha

AU - Barks, John

AU - Do, Barbara T.

AU - Laptook, Abbot R.

AU - Das, Abhik

AU - Ambalavanan, Namasivayam

AU - Van Meurs, Krisa P.

AU - Bell, Edward F.

AU - Sanchez, Pablo J.

AU - Hintz, Susan R.

AU - Wyckoff, Myra H.

AU - Stoll, Barbara J.

AU - Carlo, Waldemar A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Cranial ultrasonography

KW - Cystic periventricular leukomalacia

KW - Neurodevelopmental impairment

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