Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants.
OBJECTIVE
To assess the risk of persistent (>7 days) increases in brain parenchymal echogenicity in preterm infants and their association with known obstetric risk factors.


METHODS
Case-control study of prospectively collected data.


METHODS
A University hospital in Northern Italy.


METHODS
Eighty-five singleton infants between 24 and 34 weeks of gestation with a cranial ultrasonographic diagnosis of persistently increased parenchymal echogenicity without development of cystic degeneration, and 170 control infants with negative cranial ultrasonographic findings.


METHODS
A comparison of the prevalence of selected obstetric risk factors between infants with persistent echo-dense lesions and negative controls.


METHODS
Odds ratios of persistent echo-dense lesions including first-degree interactions between variables.


RESULTS
After adjusting for birthweight, logistic regression analysis showed that the only factor associated with an increased risk of persistent brain echo-dense lesions in infants was multiple courses of antenatal steroids (OR = 2.14, 95% CI = 1.11-4.15, P= 0.024). In this group, the risk of persistent echo-dense lesions was particularly high in: (i) mothers receiving dexamethasone rather than betamethasone (P value for interaction = 0.015) and (ii) after expectant management of pre-eclampsia or intrauterine growth retardation (P value for interaction = 0.03).


CONCLUSIONS
Multiple doses of antenatal steroids, especially dexamethasone, could influence the prevalence of persistent increases in brain parenchymal echogenicity in preterm infants.
Spinillo
Arsenio
A
Department of Obstetrics and Gynecology, IRCCS Policlinico S. Matteo, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
Chiara
Alberto
A
Bergante
Carola
C
Biancheri
Danila
D
Fabiana
DePaoli
D
Fazzi
Elisa
E
D001927:Brain Diseases / Q000000981:diagnostic imaging*; D004453:Echoencephalography; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D008423:Maternal Age; D018811:Maternal Exposure; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D013256:Steroids / Q000009:adverse effects
D013256:Steroids