Clinical Investigation | Published:

Article

White Matter Injury in Term Newborns With Neonatal Encephalopathy

Pediatric Research volume 65, pages 8589 (2009) | Download Citation

Supported, in part, by the SickKids Foundation and IHDCYH-CIHR National Grants Program (XG 07-034). Also supported by the Society for Pediatric Research—Summer Student Program [A.M.L.] and by the Bourse McLaughlin de l'Université Laval and the Fondation pour la recherche sur les maladies infantiles [V.C.]. Steven P. Miller is a Canadian Institutes of Health Research (CIHR) Clinician-Scientist and Michael Smith Foundation for Health Research (MSFHR) Scholar.

Subjects

Abstract

White matter injury (WMI) is the characteristic pattern of brain injury detected on magnetic resonance imaging in the premature newborn. Focal noncystic WMI is increasingly recognized in populations of term newborns. The aim of this study was to describe the occurrence of focal noncystic WMI in a cohort of 48 term newborns with encephalopathy studied with magnetic resonance imaging at 72 ± 12 h of life, and to identify clinical risk factors for this pattern of injury. Eleven newborns (23%; 95% CI 11–35) were found to have WMI (four minimal, three moderate, and four severe). In 10 of the 11 newborns, the WMI was associated with restricted diffusion on apparent diffusion coefficient maps. An increasing severity of WMI was associated with lower gestational age at birth (p = 0.05), but not lower birth weight. Newborns with WMI had milder encephalopathy and fewer clinical seizures relative to other newborns in the cohort. Other brain injuries were seen in three of the 11 newborns: basal nuclei predominant pattern of injury in one and cortical strokes in two. These findings suggest that WMI in the term newborn is acquired near birth and that the state of brain maturation is an important determinant of this pattern of brain injury.

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Author information

Affiliations

  1. Departments of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada

    • Amanda M Li
    • , Vann Chau
    • , Brian A Lupton
    • , Alan Hill
    • , Elke Roland
    •  & Steven P Miller
  2. Departments of Radiology, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada

    • Kenneth J Poskitt
    •  & Michael A Sargent

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Corresponding author

Correspondence to Steven P Miller.

Glossary

ADC

apparent diffusion coefficient

CHD

congenital heart disease

CT

computed tomography

DWI

diffusion-weighted imaging

NE

neonatal encephalopathy

WMI

white matter injury

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DOI

https://doi.org/10.1203/PDR.0b013e31818912d2

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