Journal article
Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants
The Journal of pediatrics, Vol.195, pp.66-72.e3
04/01/2018
DOI: 10.1016/j.jpeds.2017.11.036
PMCID: PMC5869095
PMID: 29395186
Abstract
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.
Details
- Title: Subtitle
- Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants
- Creators
- Girija Natarajan - Wayne State UniversitySeetha Shankaran - Wayne State UniversityShampa Saha - Research Triangle Park FoundationAbbot Laptook - Women & Infants Hospital of Rhode IslandAbhik Das - Research Triangle Park FoundationRosemary Higgins - National Institutes of HealthBarbara J. Stoll - The University of Texas Health Science Center at HoustonEdward F. Bell - University of IowaWaldemar A. Carlo - University of Alabama at BirminghamCarl D'Angio - University of Rochester Medical CenterSara B. DeMauro - University of PennsylvaniaPablo Sanchez - Nationwide Children's HospitalKrisa Van Meurs - Stanford UniversityBetty Vohr - Women & Infants Hospital of Rhode IslandNancy Newman - Case Western Reserve UniversityEllen Hale - Emory UniversityMichele Walsh - Case Western Reserve UniversityEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
- Contributors
- Tarah T Colaizy (Contributor) - University of Iowa, Neonatology
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.195, pp.66-72.e3
- DOI
- 10.1016/j.jpeds.2017.11.036
- PMID
- 29395186
- PMCID
- PMC5869095
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- UG1HD021385 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Center for Advancing Translational Sciences; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR001117 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 04/01/2018
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353837002771
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