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.
Department of Obstetrics and Gynecology, IRCCS Policlinico S. Matteo, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
Arsenio
A
Spinillo
Alberto
A
Chiara
Carola
C
Bergante
Danila
D
Biancheri
DePaoli
D
Fabiana
Elisa
E
Fazzi
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