Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants.

Publisher: Mosby Country of Publication: United States NLM ID: 0375410 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6833 (Electronic) Linking ISSN: 00223476 NLM ISO Abbreviation: J Pediatr Subsets: MEDLINE

Original Publication: St. Louis, MO : Mosby

Hydrocephalus*/diagnostic imaging ; Hydrocephalus*/epidemiology ; Intracranial Hemorrhages*/diagnostic imaging ; Intracranial Hemorrhages*/epidemiology ; Leukomalacia, Periventricular*/diagnostic imaging ; Leukomalacia, Periventricular*/epidemiology ; Neonatal Screening*; Brain/*diagnostic imaging; Adult ; Cesarean Section/statistics & numerical data ; Chorioamnionitis/diagnosis ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Logistic Models ; Pregnancy ; Prospective Studies ; Registries ; Resuscitation/statistics & numerical data ; Risk Factors ; Young Adult

Objectives: To describe the frequency and findings of cranial imaging in moderately preterm infants (born at 29 ^0/7 -33 ^6/7 weeks of gestation) across centers, and to examine the association between abnormal imaging and clinical characteristics.
Study Design: We used data from the Neonatal Research Network Moderately Preterm Registry, including the most severe early (≤28 days) and late (>28 days) cranial imaging. Stepwise logistic regression and CART analysis were performed after adjustment for gestational age, antenatal steroid use, and center.
Results: Among 7021 infants, 4184 (60%) underwent cranial imaging. These infants had lower gestational ages and birth weights and higher rates of small for gestational age, outborn birth, cesarean delivery, neonatal resuscitation, and treatment with surfactant, compared with those without imaging (P < .0001). Imaging abnormalities noted in 15% of the infants included any intracranial hemorrhage (13.2%), grades 3-4 intracranial hemorrhage (1.7%), cystic periventricular leukomalacia (2.6%), and ventriculomegaly (6.6%). Histologic chorioamnionitis (OR, 1.47; 95% CI, 1.19-1.83), gestational age (0.95; 95% CI, 0.94-0.97), antenatal steroids (OR, 0.55; 95% CI, 0.41-0.74), and cesarean delivery (OR, 0.66; 95% CI, 0.53-0.81) were associated with abnormal imaging. The center with the highest rate of cranial imaging, compared with the lowest, had a higher risk of abnormal imaging (OR, 2.08; 95% CI, 1.10-3.92). On the classification and regression-tree model, cesarean delivery, center, antenatal steroids, and chorioamnionitis, in that order, predicted abnormal imaging.
Conclusion: Among the 60% of moderately preterm infants with cranial imaging, 15% had intracranial hemorrhage, cystic periventricular leukomalacia or late ventriculomegaly. Further correlation of imaging and long-term neurodevelopmental outcomes in moderately preterm infants is needed.
(Copyright © 2017 Elsevier Inc. All rights reserved.)

Biol Neonate. 2003;83(3):166-70. (PMID: 12660432)
Neurology. 2002 Jun 25;58(12 ):1726-38. (PMID: 12084869)
J Pediatr. 2014 May;164(5):1005-1011.e3. (PMID: 24589078)
Clin Perinatol. 2013 Dec;40(4):601-10. (PMID: 24182950)
J Pediatr. 2011 Feb;158(2):239-44.e1. (PMID: 20828716)
BJOG. 2004 Dec;111(12):1365-71. (PMID: 15663120)
J Matern Fetal Neonatal Med. 2012 Feb;25(2):116-9. (PMID: 21381878)
Pediatrics. 1972 Oct;50(4):515-25. (PMID: 4561295)
Brain Imaging Behav. 2016 Mar;10 (1):41-9. (PMID: 25739350)
J Pediatr. 2001 Jan;138(1):101-4. (PMID: 11148520)
Radiology. 2014 Oct;273(1):232-40. (PMID: 24914576)
Pediatr Radiol. 2007 Dec;37(12 ):1201-8. (PMID: 17901950)
Pediatr Res. 2006 Mar;59(3):478-83. (PMID: 16492993)
Clin Perinatol. 2013 Dec;40(4):723-38. (PMID: 24182958)
Am J Perinatol. 2007 Jan;24(1):17-21. (PMID: 17094042)
N Engl J Med. 2008 Jul 17;359(3):262-73. (PMID: 18635431)
Am J Obstet Gynecol. 2006 Sep;195(3):803-8. (PMID: 16949415)
J Comp Neurol. 2005 Apr 4;484(2):156-67. (PMID: 15736232)
Semin Perinatol. 2006 Feb;30(1):8-15. (PMID: 16549207)
Pediatr Radiol. 1999 May;29(5):347-52. (PMID: 10382212)
Neonatology. 2011;99(3):177-87. (PMID: 20881433)
Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004454. (PMID: 16856047)
Pediatr Res. 2017 Aug;82(2):297-304. (PMID: 28419085)
Arch Dis Child Fetal Neonatal Ed. 2006 Jul;91(4):F238-44. (PMID: 16611647)
J Pediatr. 2007 Jun;150(6):592-6, 596.e1-5. (PMID: 17517240)
Natl Vital Stat Rep. 2015 Dec;64(12 ):1-64. (PMID: 26727629)
J Pediatr. 2009 Feb;154(2):169-76. (PMID: 19081113)
J Pediatr. 1994 Oct;125(4):623-5. (PMID: 7931887)
Obstet Gynecol. 2000 Aug;96(2):172-7. (PMID: 10908758)
J Paediatr Child Health. 1998 Feb;34(1):57-9. (PMID: 9568943)
Adv Neonatal Care. 2007 Apr;7(2):80-7. (PMID: 17605448)

UG1 HD068263 United States HD NICHD NIH HHS; U10 HD021385 United States HD NICHD NIH HHS; U10 HD021364 United States HD NICHD NIH HHS; UG1 HD027904 United States HD NICHD NIH HHS; UG1 HD027880 United States HD NICHD NIH HHS; U10 HD068278 United States HD NICHD NIH HHS; U10 HD053089 United States HD NICHD NIH HHS; U10 HD027856 United States HD NICHD NIH HHS; U10 HD021373 United States HD NICHD NIH HHS; U10 HD027880 United States HD NICHD NIH HHS; UG1 HD027853 United States HD NICHD NIH HHS; U10 HD053109 United States HD NICHD NIH HHS; UG1 HD087229 United States HD NICHD NIH HHS; UG1 HD040689 United States HD NICHD NIH HHS; U10 HD040689 United States HD NICHD NIH HHS; U10 HD040492 United States HD NICHD NIH HHS; U10 HD027853 United States HD NICHD NIH HHS; U10 HD027904 United States HD NICHD NIH HHS; U10 HD068244 United States HD NICHD NIH HHS; U10 HD068263 United States HD NICHD NIH HHS; U10 HD068270 United States HD NICHD NIH HHS; U10 HD027851 United States HD NICHD NIH HHS; UG1 HD021385 United States HD NICHD NIH HHS; UL1 TR001425 United States TR NCATS NIH HHS; UG1 HD021364 United States HD NICHD NIH HHS; UL1 TR001117 United States TR NCATS NIH HHS; U10 HD068284 United States HD NICHD NIH HHS; U10 HD034216 United States HD NICHD NIH HHS; U10 HD036790 United States HD NICHD NIH HHS

Investigator: RA Polin, Division of Neonatology, College of Physicians and Surgeons, Columbia University.; M Keszler, Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.; AM Hensman, Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.; E Vieira, Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.; AM Hibbs, Case Western Reserve University, Rainbow Babies & Children's Hospital.; BS Siner, Case Western Reserve University, Rainbow Babies & Children's Hospital.; EK Pallotto, Children's Mercy Hospital.; HW Kilbride, Children's Mercy Hospital.; C Gauldin, Children's Mercy Hospital.; A Holmes, Children's Mercy Hospital.; K Johnson, Children's Mercy Hospital.; SG Kallapur, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; C Grisby, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; B Alexander, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; EE Fischer, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; L Jackson, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; K Kirker, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; J Jennings, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; S Wuertz, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; G Muthig, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Good Samaritan Hospital.; RN Goldberg, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; J Finkle, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; KA Fisher, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; MM Laughon, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; CL Bose, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; J Bernhardt, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; C Clark, Duke University School of Medicine, University Hospital, University of North Carolina, Duke Regional Hospital.; DP Carlton, Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, Emory University Hospital Midtown.; Y Loggins, Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, Emory University Hospital Midtown.; DI Bottcher, Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, Emory University Hospital Midtown.; SW Archer, Eunice Kennedy Shriver National Institute of Child Health and Human Development.; G Sokol, Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children at Indiana University Health, Eskenazi Health.; DE Herron, Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children at Indiana University Health, Eskenazi Health.; LD Nelin, Nationwide Children's Hospital and the Ohio State University Medical Center.; SR Jadcherla, Nationwide Children's Hospital and the Ohio State University Medical Center.; P Luzader, Nationwide Children's Hospital and the Ohio State University Medical Center.; NA Parikh, Nationwide Children's Hospital and the Ohio State University Medical Center.; MD Nist, Nationwide Children's Hospital and the Ohio State University Medical Center.; J Fuller, Nationwide Children's Hospital and the Ohio State University Medical Center.; J Gutentag, Nationwide Children's Hospital and the Ohio State University Medical Center.; ME Jones, Nationwide Children's Hospital and the Ohio State University Medical Center.; S McGregor, Nationwide Children's Hospital and the Ohio State University Medical Center.; E Rodgers, Nationwide Children's Hospital and the Ohio State University Medical Center.; JA Ulloa, Nationwide Children's Hospital and the Ohio State University Medical Center.; T Wolfe, Nationwide Children's Hospital and the Ohio State University Medical Center.; D Wallace, RTI International.; KM Zaterka-Baxter, RTI International.; M Crawford, RTI International.; J Gabrio, RTI International.; J O'Donnell Auman, RTI International.; DK Stevenson, Stanford University and Lucile Packard Children's Hospital.; MB Ball, Stanford University and Lucile Packard Children's Hospital.; MS Proud, Stanford University and Lucile Packard Children's Hospital.; N Ambalavanan, University of Alabama at Birmingham Health System and Children's Hospital of Alabama.; MV Collins, University of Alabama at Birmingham Health System and Children's Hospital of Alabama.; SS Cosby, University of Alabama at Birmingham Health System and Children's Hospital of Alabama.; U Devaskar, University of California - Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, Olive View Medical Center.; M Garg, University of California - Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, Olive View Medical Center.; T Chanlaw, University of California - Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, Olive View Medical Center.; R Geller, University of California - Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, Olive View Medical Center.; TT Colaizy, University of Iowa and Mercy Medical Center.; DL Ellsbury, University of Iowa and Mercy Medical Center.; JE Brumbaugh, University of Iowa and Mercy Medical Center.; KJ Johnson, University of Iowa and Mercy Medical Center.; DB Campbell, University of Iowa and Mercy Medical Center.; JR Walker, University of Iowa and Mercy Medical Center.; RK Ohls, University of New Mexico Health Sciences Center.; CB Lacy, University of New Mexico Health Sciences Center.; SS Beauman, University of New Mexico Health Sciences Center.; C Hartenberger, University of New Mexico Health Sciences Center.; H Kirpalani, University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.; AS Chaudhary, University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.; S Abbasi, University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.; T Mancini, University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.; D Cucinotta, University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.; S Lakshminrusimha, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; AM Scorsone, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; J Hunn, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; R Jensen, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; HIM Wadkins, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; S Guilford, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; A Williams, University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's and Children's Hospital of Buffalo.; M Wyckoff, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.; LP Brion, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.; DM Vasil, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.; L Chen, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.; LE Torres, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.; JE Tyson, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; J Arldt-McAlister, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; C Garcia, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; K Martin, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; GE McDavid, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; SL Wright, University of Texas Health Science Center, Houston Medical School, Children's Memorial Hermann Hospital.; A Pappas, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; J Barks, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; R Bara, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; S Handel, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; DF White, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; M Christensen, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.; SA Wiggins, Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.
Keywords: intracranial hemorrhage; moderate preterm; periventricular leukomalacia; ultrasound

Date Created: 20180204 Date Completed: 20190215 Latest Revision: 20240620

20240620

PMC5869095

10.1016/j.jpeds.2017.11.036

29395186