title: Neurodevelopmental outcome of infants with unilateral or bilateral periventricular hemorrhagic infarction.
abstract: OBJECTIVE
  Periventricular hemorrhagic infarction (PVHI) is a major contributing factor to poor neurodevelopmental outcomes in preterm infants. We hypothesized that surviving infants with unilateral PVHI would have more favorable outcomes than those with bilateral PVHI.
  
  
  METHODS
  This was a multicenter, retrospective study of infants who were admitted to 3 NICUs in North Carolina from 1998 to 2004. The clinical course and late neuroimaging studies and neurodevelopmental outcomes of 69 infants who weighed <1500 g and had confirmed PVHI on early cranial ultrasonography were reviewed. A predictive model for Bayley Scales of Infant Development, Second Edition, Mental Developmental Index (MDI) <70 was constructed by using radiologic and clinical variables.
  
  
  RESULTS
  Infants with unilateral PVHI had higher median MDI (82 vs 49) and Psychomotor Developmental Index (53 vs 49) than infants with bilateral PVHI. Infants with unilateral PVHI were less likely to have severe cerebral palsy (adjusted odds ratio: 0.15 [95% confidence interval (CI): 0.05-0.45]) than infants with bilateral PVHI. Infants who had unilateral PVHI and developed periventricular leukomalacia and retinopathy of prematurity that required surgery had an increased probability of having MDI <70 compared with those without these complications (probability of MDI <70: 89% [95% CI: 0.64-1.00] vs 11% [95% CI: 0.01-0.28]).
  
  
  CONCLUSIONS
  Infants with unilateral PVHI had better motor and cognitive outcomes than infants with bilateral PVHI. By combining laterality of PVHI, periventricular leukomalacia, and retinopathy of prematurity it is possible to estimate the probability of having an MDI <70, which will assist clinicians when counseling families.
authors: Department of Pediatrics, Monroe Carell Children's Hospital at Vanderbilt, Nashville, Tennessee 37232-9544, USA. nathalie.maitre@vanderbilt.edu
authors: Nathalie L
authors: NL
authors: Maitre
authors: Diane D
authors: DD
authors: Marshall
authors: Wayne A
authors: WA
authors: Price
authors: James C
authors: JC
authors: Slaughter
authors: Thomas M
authors: TM
authors: O'Shea
authors: Charles
authors: C
authors: Maxfield
authors: Ricki F
authors: RF
authors: Goldstein
mesh_terms: D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000401:mortality; D002552:Cerebral Ventricles / Q000098:blood supply*; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000401:mortality; D004292:Dominance, Cerebral / Q000502:physiology; D004453:Echoencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D007969:Leukomalacia, Periventricular / Q000175:diagnosis* / Q000401:mortality; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009657:North Carolina; D011336:Probability; D012178:Retinopathy of Prematurity / Q000175:diagnosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014057:Tomography, X-Ray Computed