title: Antecedents of perinatal cerebral white matter damage with and without intraventricular hemorrhage in very preterm newborns.
abstract: BACKGROUND
  Isolated periventricular leukomalacia, defined as periventricular leukomalacia unaccompanied by intraventricular hemorrhage, is reportedly increased in newborns with systemic hypotension and in infants who received treatment for systemic hypotension or a patent ductus arteriosus.
  
  
  METHODS
  This study sought to determine if the risk profile of one or more hypoechoic lesions unaccompanied by intraventricular hemorrhage, our surrogate for isolated periventricular leukomalacia, differs from that of one or more hypoechoic lesions preceded or accompanied by intraventricular hemorrhage. We compared extremely preterm infants (i.e., gestation 23-27 weeks) with each of these entities to 885 extremely preterm infants who had neither an isolated hypoechoic lesion nor a hypoechoic lesion preceded or accompanied by intraventricular hemorrhage.
  
  
  RESULTS
  The risk of a hypoechoic lesion with intraventricular hemorrhage (N = 61) was associated with gestation <25 weeks, high Score for Acute Neonatal Physiology, early recurrent or prolonged acidemia, analgesic exposure, and mechanical ventilation 1 week after birth.
  
  
  CONCLUSIONS
  In this large, multicenter sample of extremely low gestational age newborns, the risk profile of a hypoechoic lesion unaccompanied by intraventricular hemorrhage differed from that of a hypoechoic lesion with intraventricular hemorrhage. This suggests that hypoechoic lesions accompanied or preceded by intraventricular hemorrhage (our surrogate for periventricular hemorrhagic infarction) may have a different causal pathway than hypoechoic lesions without intraventricular hemorrhage, our surrogate for periventricular leukomalacia.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas, USA. wellslogan@usa.net
authors.forename: J Wells
authors.initials: JW
authors.lastname: Logan
authors.forename: Sjirk J
authors.initials: SJ
authors.lastname: Westra
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.forename: Karl
authors.initials: K
authors.lastname: Kuban
authors.forename: Nigel
authors.initials: N
authors.lastname: Paneth
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging; D007969:Leukomalacia, Periventricular / Q000150:complications*; D008297:Male; D012307:Risk Factors; D014463:Ultrasonography