Abstract
Objectives: To describe the frequency and findings of cranial imaging in moderately preterm infants (born at 290/7-336/7 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 66-72.e3 |
| Journal | Journal of Pediatrics |
| Volume | 195 |
| DOIs | |
| State | Published - Apr 1 2018 |
| Externally published | Yes |
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Keywords
- intracranial hemorrhage
- moderate preterm
- periventricular leukomalacia
- ultrasound
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants. / Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.
In: Journal of Pediatrics, Vol. 195, 01.04.2018, p. 66-72.e3.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antecedents and Outcomes of Abnormal Cranial Imaging in Moderately Preterm Infants
AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
AU - Natarajan, Girija
AU - Shankaran, Seetha
AU - Saha, Shampa
AU - Laptook, Abbot
AU - Das, Abhik
AU - Higgins, Rosemary
AU - Stoll, Barbara J.
AU - Bell, Edward F.
AU - Carlo, Waldemar A.
AU - D'Angio, Carl
AU - DeMauro, Sara B.
AU - Sanchez, Pablo
AU - Van Meurs, Krisa
AU - Vohr, Betty
AU - Newman, Nancy
AU - Hale, Ellen
AU - Walsh, Michele
AU - Polin, Richard A.
AU - Keszler, Martin
AU - Hensman, Angelita M.
AU - Vieira, Elisa
AU - Hibbs, Anna Marie
AU - Siner, Bonnie S.
AU - Pallotto, Eugenia K.
AU - Kilbride, Howard W.
AU - Gauldin, Cheri
AU - Holmes, Anne
AU - Johnson, Kathy
AU - Kallapur, Suhas G.
AU - Grisby, Cathy
AU - Alexander, Barbara
AU - Fischer, Estelle E.
AU - Jackson, Lenora
AU - Kirker, Kristin
AU - Jennings, Jennifer
AU - Wuertz, Sandra
AU - Muthig, Greg
AU - Goldberg, Ronald N.
AU - Finkle, Joanne
AU - Fisher, Kimberley A.
AU - Laughon, Matthew M.
AU - Bose, Carl L.
AU - Bernhardt, Janice
AU - Clark, Cindy
AU - Carlton, David P.
AU - Loggins, Yvonne
AU - Bottcher, Diane I.
AU - Archer, Stephanie Wilson
AU - Sokol, Greg
AU - Lakshminrusimha, Satyanarayana
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Objectives: To describe the frequency and findings of cranial imaging in moderately preterm infants (born at 290/7-336/7 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.
AB - Objectives: To describe the frequency and findings of cranial imaging in moderately preterm infants (born at 290/7-336/7 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.
KW - intracranial hemorrhage
KW - moderate preterm
KW - periventricular leukomalacia
KW - ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85040770637&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040770637&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2017.11.036
DO - 10.1016/j.jpeds.2017.11.036
M3 - Article
C2 - 29395186
AN - SCOPUS:85040770637
VL - 195
SP - 66-72.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
ER -