Postnatal cystic germinolysis and neonatal chronic lung disease: evaluation of risk factors and neurodevelopmental outcome

Abstract

Late neonatal onset of subependymal germinolysis in the caudothalamic groove has been associated with chronic lung disease. This clinical study had two objectives: (i) to clarify the link between chronic lung disease and germinolysis; and (ii) to evaluate the impact of germinolysis on neuromotor development of patients with chronic lung disease. Twenty-four patients with chronic lung disease and germinolysis were compared to 24 patients, matched for gestational age, with chronic lung disease but without germinolysis. There was no difference in the occurrence of perinatal risk factors for impaired cerebral development (small for gestational age at birth, impaired postnatal growth, postnatal steroid treatment, duration of mechanical ventilation) or in the presence of clinical markers potentially related to cerebral ischaemia (need for treatment of hypotension or poor perfusion, seizures, oliguria, hypocapnia). Both groups showed a high incidence of clinically significant developmental delay (mean Bayley Development Index of 72+/-23 [SD] in both groups), regardless of the presence or absence of germinolysis. We were unable to clarify the link between chronic lung disease and germinolysis, and it seems that germinolysis has no major impact on neurodevelopmental outcome of patients with chronic lung disease.