Early periventricular leukomalacia in preterm neonates

Abstract

Background: Preterm neonates are at increased risk for brain injury. More than 10% will sustain neurological injuries leading to significant learning disabilities, motor developmental delay, cerebral palsy, seizures and mental retardation. Periventricular leukomalacia (PVL) is the most common form of white matter injury of prematurity. The objective of the present study was to identify the incidence of early periventricular leukomalacia (PVL) and its associated risk factors in the study group.Methods: All preterm neonates with either Gestational age <32weeks and/or Birth weight <1500 grams who were admitted to Neonatal Intensive Care Unit within the period of 1st November 2013 to 30th April 2015 were taken for study. A total of 112 babies met the inclusion criteria but 104 were finally taken into the study. Screening of intraventricular haemorrhage and early PVL changes in VLBW babies was done by neurosonogram on day 3 and day 14 of life by a single well qualified radiologist. Follow up cranial ultrasound was done weekly for the babies who were diagnosed to have IVH and/or PVL by day 14 of life.Results: The incidence of early periventricular leukomalacia in very low birth weight babies in present study was 7.7%. It was seen that 87.5% babies had periventricular flares and 12.5% babies had cystic changes. It was seen that birth weight<1000grams (OR 0.006; CI:0.00-0.50; p value 0.023) and neonatal sepsis (OR 80.9; CI:1.65-3947.6;p value 0.027) significantly increased the risk of developing PVL in VLBW babies. The duration of hospital stay was found to be significantly increased in babies having PVL.Conclusions: The incidence of early periventricular leukomalacia in babies born <32weeks gestation and/or birth weight<1500grams is 7.7%. Birth weight <1000 grams and neonatal sepsis were found to increase the risk of periventricular leukomalacia in these babies.