Isolated parenchymal lesions on cranial ultrasound in very preterm infants in the context of maternal infection.

Full Abstract

AIM:
To explore the associations between a clinical diagnosis of maternal infection (CDMI) and findings on the initial cranial ultrasound scan in very preterm infants.

METHODS:
Among infants born at less than 32 weeks gestation, cases of CDMI and controls were identified on the basis of routinely available obstetric data. Neonatal cranial ultrasound scans carried out soon after birth were retrospectively reviewed for evidence of parenchymal echodensity (PED), intraventricular haemorrhage (IVH) or PED contiguous with IVH.

RESULTS:
Any PED was identified in 20/40 (50%) cases of CDMI and 9/30 (30%) of controls. Logistic regression was used to adjust for differences between the two study groups. When compared with normal scans, isolated PED was more likely with CDMI odds ratio, OR (95% confidence interval, CI), 41.8 (2.64, 662) and lower Apgar score at 5 min 2.89 (1.05, 7.98). IVH was more likely with lower gestational age, OR for each completed week of gestation 0.64 (0.46, 0.88) and a protective effect of female sex, OR 0.25 (0.063, 0.98), PED contiguous with IVH was more likely with lower gestational age OR 0.59 (0.336, 1.04).

CONCLUSIONS:
CDMI may be associated with isolated PED in very preterm infants. We speculate that isolated PED (including "flares") identify infants who have sustained early brain injury because of intrauterine infection. Isolated PED may be a useful intermediate outcome in perinatal cohort studies.

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Author information

Author/s: Turner, M A (MA); Vause, S (S); Howell, L (L); Wood, D (D); Herbert, E (E); Rimmer, S (S); Chiswick, M L (ML); D'Souza, S W (SW);

Affiliation: Academic Unit of Child Health, University of Manchester, UK. mark.turner(-atsign-)liverpool.ac.uk

Journal and publication information

Publication Type: Journal Article

Journal: Early human development (Early Hum Dev), published in Ireland. (Language: eng)

Reference: 2007-Jan; vol 83 (issue 1) : pp 63-8

Dates: Created 2007/01/09; Completed 2007/03/19;

PMID: 16820273, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Apgar Score
Brain Diseases - epidemiology; etiology; ultrasonography
Echoencephalography
Female
Humans
Infant, Newborn
Infant, Premature

Infant, Very Low Birth Weight
Male
Pregnancy
Pregnancy Complications, Infectious - epidemiology; ultrasonography
Retrospective Studies
Risk Factors
Skull - ultrasonography

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