Abstract
Background: In contrast to IVH and PVL, it is not yet clear, if minor abnormalities on neonatal cranial ultrasound -periventricular flares, ventricularmegaly, widened interhemispherics fissure or extracerebral space as signs of cerebral atrophy–are related to adverse outcome. Aim of the present study was to correlate these ultrasound findings to neurodevelopmental outcome at three years of age.
Methods: In 1997 all preterm infants born in our unit with a gestational age less than 32 weeks or birth weight below 1500g were prospectively enrolled in the study. Standard cranial ultrasound examinations were performed at predefined intervals between the first day of life and discharge. Ultrasound scans were analysed by 3 independent examiners for the presence of IVH, parenchymal hemorrhage, PVL, periventricular flares, and signs of cerebral atrophy (ventricularmegaly, widened interhemispheric fissure, enlarged extracerebral spaces). At the age of three years Bayley Scales of Infant Development II were performed.
Results: Eighty-seven preterm infants were enrolled (birth weight 430–2500g (median 1200g), gestational age 24–34 weeks (median 29 weeks)). Eighty-one infants survived (93%). In 11 infants IVH I, in 7 infants IVH II, in one IVH III, and in 3 infants IVH III plus parenchymal hemorrhage were diagnosed. All infants with IVH III plus parenchymal hemorrhage died. Forty-two infants exhibited periventricular flares, in 16 infants these were only detectable within the first two weeks of life, in 26 infants the flares persisted longer than two weeks. At discharge, 36 preterm infants had signs of cerebral atrophy. Neurodevelopmental outcome at three years of age was assessed by Bayley Scales in 64 infants (79% of all survivors). Infants with IVH II had significant lower MDI and PDI-scores than children without hemorrhage. Infants who presented with signs of cerebral atrophy at discharge had significant lower MDI (atrophy 95.7/no atrophy 103.1; p= 0.043)-, PDI- (atrophy 98.8/no atrophy 106.9; p= 0.04) and Behaviour Rating Scale (atrophy 50.5/no atrophy 69.5; p= 0.022) -scores than infants without signs of cerebral atrophy. Periventricular flares and IVH I had no impact on the neurodevelopmental outcome.
Conclusion: Our data suggest that in addition to IVH and PVL the sonographic diagnosis of a cerebral atrophy at discharge is related to an unfavourable neurodevelopmental outcome at three years of age.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Horsch, S., Müntjes, C., Franz, A. et al. 112 Sonographic Diagnosis of Cerebral Atrophy at Discharge is Related to Unfavourable Neurodevelopmental Outcome at Three Years of Age. Pediatr Res 56, 483 (2004). https://doi.org/10.1203/00006450-200409000-00135
Issue Date:
DOI: https://doi.org/10.1203/00006450-200409000-00135