Indices of hemodynamic and respiratory functions in premature infants at risk for the development of cerebral white matter injury.
OBJECTIVE
To examine potential differences in clinical risk factors, including indices of hemodynamic and respiratory functions, of premature infants developing periventricular hemorrhagic infarction (PHI) or periventricular leukomalacia (PVL).


METHODS
Indices of hemodynamic stability and respiratory function were measured prospectively during the first week of life in a cohort of 100 premature infants with respiratory distress. Maternal history was retrospectively reviewed. These data were correlated with cranial ultrasonography using one-way ANOVA, Bonferroni multiple comparisons, and Wilcoxon rank sum tests. Longitudinal analysis was performed using Generalized Estimating Equations.


RESULTS
Fifty-two infants with normal cranial ultrasound studies were compared to 12 with PHI and 9 with PVL. Infants developing PHI had significantly lower birth weights, lower Apgar scores, were more often male and multiple gestations, and required more vasopressor support than infants with normal ultrasound studies. Infants with PHI had significantly worse indices of respiratory function than either normal infants or those with PVL. PVL was significantly associated with maternal chorioamnionitis, whereas PHI was not.


CONCLUSIONS
These data suggest that there are important differences in the pathogenesis of PHI and PVL. A clear understanding of these differences is required before future preventive strategies can be formulated.
Bass
W Thomas
WT
Division of Neonatal Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Schultz
Seth J
SJ
Burke
Bonnie L
BL
White
Larry E
LE
Khan
Jamil H
JH
Karlowicz
M Gary
MG
D001925:Brain Damage, Chronic / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002821:Chorioamnionitis / Q000150:complications; D004453:Echoencephalography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors