A Study on the Incidence and Risk factors of Cystic Periventricular Leukomalacia in very Low Birth Weight Infants.

Lee,  Soo Hyun; Kim,  Sung Hye; Lee,  Kye Hyang; You,  Dong Kil; Choi,  Suk Joo; Hwang,  Jong Hee; Choi,  Chang Won; Shim,  Jae Won; Ko,  Sun Young; Yang,  Soon Ha; Chang,  Yun Sil; Park,  Won Soon

Original Article

Journal of the Korean Society of Neonatology 2003;10(1):61-66.
Published online May 1, 2003.

A Study on the Incidence and Risk factors of Cystic Periventricular Leukomalacia in very Low Birth Weight Infants.

Soo Hyun Lee, Sung Hye Kim, Kye Hyang Lee, Dong Kil You, Suk Joo Choi, Jong Hee Hwang, Chang Won Choi, Jae Won Shim, Sun Young Ko, Soon Ha Yang, Yun Sil Chang, Won Soon Park

¹Department of Pediatrics, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea. wspark@smc.samsung.ac.kr
²Department of Obstetrics and Gynecology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea.
³Department of Pediatrics, Kangbuk Samsung Medical Center, Seoul, Korea.
⁴Department of Pediatrics, Samsung Cheil Hospital, Seoul, Korea.

극소 저출생 체중아에서 낭종성 뇌실주위 백질연화증의 발생빈도와 위험인자에 대한 분석

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Abstract

PURPOSE
Our study was carried out to estimate the incidence of cystic periventricular leukomalacia (CPVL) and to identify the risk factors for CPVL. METHODS: The medical records and cranial ultrasound scan were reviewed for 321 infants weighing less than 1, 500 g who lived more than 28 days and admitted to the NICU at Samsung Medical Center from October 1995 to December 2001. A multiple logistic regression was performed to identify which factors were independently associated with CPVL. RESULT: CPVL developed in 19 (5.9%) infants of 1, 188+/-236 g birth weight and 28(+6)+/-2(+4) weeks gestational age. Incidence of CPVL according to birth weight and gestational age were as follows respectively: <750 g 5.3%, 750-999 g 5.5%, 1, 000-1, 249 g 3.9%, 1, 250-1, 499 g 7.9% and <25weeks 8.3%, 25-26weeks 6.7%, 27-28weeks 6.5%, 29-30weeks 2.7%, 31-32weeks 11.1%. The mean day of diagnosis of CPVL was 41+/-33 days. Univriate analysis indicate that two clinical variables, prolonged ventilator duration (CPVL: control, 35+/-64 days vs 17+/-26 days, P=0.0184) and severe intraventricular hemorrhage (IVH) (21% vs 2.7%, P=0.0324), were significant predictors of CPVL. The odds ratio estimate and 95% confidence limits are 1.012 and 1.003 to 1.022, respectively for prolonged ventilator duration; 2.6 and 1.044 to 6.602, respectively for severe IVH. CONCLUSIONS: These data suggest that prolonged ventilator duration and severe IVH increase the risk for development of CPVL.

Key Words: Cystic periventricular leukomalacia; Very low birth weight; Incidence; Risk factors