MRI findings and analysis of risk factors for brain injury in premature infants with bronchopulmonary dysplasia

Abstract

Objective To investigate the correlation between brain injury and premature infants with bronchopulmonary dysplasia (BPD) and to analyze the risk factors of brain injury in premature infants with BPD based on MRI changes. Methods A total of 113 premature infants diagnosed with BPD were studied as case group from January 2010 to December 2014 at the neonatal ward of Shengjing Hospital of China Medical University.One hundred and sixty-two premature infants without BPD were selected as control group.There were no significant differences in gestational age and birth weight between the two groups.All cases were performed MRI examination in hospital.The occurrence of brain injuries(white matter injury and intracranial hemorrhage) were compared based on MRI changes between the two groups, and the risk factors of brain injury in case group were analyzed. Results The case group and control group were performed MRI on (33.73±16.00) d, (24.40±12.29) d after birth respectively.The ratio of brain injury, intracranial hemorrhage, cerebral white matter damage and severe brain injury of case group was higher than those of the control group(48.7% vs. 32.7%, 31.9% vs. 21.6%, 31.9% vs. 21.6%, 16.8% vs. 8.6%, respectively). The differences were significant in the ratio of brain injury and severe brain injury (P=0.008, P=0.040, respectively). Logistic regression analysis showed that postnatal infection was a risk factor for brain injury of the case group(OR=2.21, 95%CI 1.04~4.72, P<0.05). Conclusion More brain injury(including the white matter injury and intracranial hemorrhage) and severe brain injury(including grade III~IV intraventricular hemorrhage and periventricular leukomalacia) are detected in premature infants with BPD.Postnatal infection is a risk factor of brain injury for premature infants with BPD. Key words: Premature infants; Bronchopulmonary dysplasia; Brain injury; Magnetic resonance imaging