ABSTRACT
Periventricular leukomalacia (PVL) is one of the most commonly seen neuropathologic
lesions and is related to many neurodevelopmental handicaps in premature infants.
Periventricular echogenicities (PVE) are considered to be at the milder end of the
spectrum of PVL, and thus might affect the neurodevelopment of the preterm infants
as well. In this retrospective cohort study medical records of 257 preterm infants
who were discharged from our neonatal intensive care unit (NICU) during October 1996
to August 2000 were reviewed. A total of 114 records of preterm infants fulfilling
our criteria were included in the survey. On the basis of the craniosonographic findings
and birth history, the candidates were divided into three subgroups: group 1 (control)
included infants with normal craniosonographic image during the neonatal period; group
2 included infants with PVEs for < 2 weeks during the neonatal period; group 3 included
infants with PVEs≥ 2 weeks during the neonatal period. Neurodevelopmental assessment
using the Bayley Scale of Infant Development II at 6, 12, and 18 months of corrected
age of each group was compared. There were no significant differences among the three
groups in gestational age, birth weight, and gender prevalence. Infants in group 3
had lower Mental Developmental Index and Psychomotor Developmental Index scores as
compared with those in groups 1 and 2 at 6 (p< 0.01), 12 (p < 0.001), and 18 (p < 0.01) months of corrected age, respectively. In conclusion, infants with PVEs that
persisted for at least a 2-week period have significantly higher risk of delayed developmental
outcomes as compared with infants with normal craniosonography or infants with PVEs
that persisted for less than 2 weeks. It might be prudent to arrange therapeutic intervention
for rehabilitation to these high-risk infants as early as possible to reduce the intensity
of possible handicap in the future.
KEYWORDS
Periventricular echogenicity,mental development delay - psychomotor developmental
delay
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Chung-Bin HuangM.D.
Section of Neonatology, Department of Pediatrics
Chang-Gung Children's Hospital, 12333 Ta-Pei Road
Niaosung, Kaohsiung 833, Taiwan, Republic of China