title: Clinical Risk Factors for Punctate White Matter Lesions on Early Magnetic Resonance Imaging in Preterm Newborns.
abstract: To identify clinical risk factors for punctate white matter lesions (PWML) on early magnetic resonance imaging (MRI) in 2 cohorts of newborns born extremely preterm in different neonatal centers.
  
  
  
  A total of 250 newborns born preterm at less than 28 weeks of gestation (mean 26.4 ± 1.1 weeks) with an early MRI were identified from 2 neonatal centers, in Vancouver, Canada (cohort A, n = 100) and Utrecht, the Netherlands (cohort B, n = 150). Cohort A was imaged as part of a prospective research study and cohort B was imaged as part of routine clinical care. PWML were defined as cluster type foci of hyperintensity on T1-weighted imaging and were identified at a mean postmenstrual age of 31.1 (±1.9) weeks. Multivariable analysis was used to identify clinical factors predictive of PWML.
  
  
  
  Cluster type PWML were found in 47 newborns born extremely preterm (18.8%) and were more common in cohort A (32%) than in cohort B (10%). Newborns in cohort A generally were sicker than those in cohort B. Multivariable analyses revealed that greater birth weight (B = 0.002; P < .02), grade II-III intraventricular hemorrhage (B = 0.83; P < .02), and cohort A (B = 1.34; P < .0001) were independent predictors of PWML.
  
  
  
  Several risk factors for PWML on early MRI were identified. The interaction among birth weight, intraventricular hemorrhage, and other aspects of postnatal illness as risk factors for PWML warrants further investigation in newborns born extremely preterm and may help to identify modifiable risk factors for PWML.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nienke
authors.initials: N
authors.lastname: Wagenaar
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, University of British Columbia, British Columbia Children's and Women's Hospitals, Child and Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Vann
authors.initials: V
authors.lastname: Chau
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Karina J
authors.initials: KJ
authors.lastname: Kersbergen
authors.affiliation: Department of Pediatrics, University of British Columbia, British Columbia Children's and Women's Hospitals, Child and Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Poskitt
authors.affiliation: Department of Pediatrics, University of British Columbia, British Columbia Children's and Women's Hospitals, Child and Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Grunau
authors.affiliation: Department of Pediatrics, University of British Columbia, British Columbia Children's and Women's Hospitals, Child and Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Synnes
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emma G
authors.initials: EG
authors.lastname: Duerden
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, University of British Columbia, British Columbia Children's and Women's Hospitals, Child and Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Miller
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: m.benders@umcutrecht.nl.
authors.forename: Manon J N L
authors.initials: MJNL
authors.lastname: Benders
mesh_terms: D002170:Canada; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D012307:Risk Factors; D066127:White Matter / Q000473:pathology*
keywords: magnetic resonance imaging; neonate; premature; white matter injury