Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (2): 114-119 DOI: 10.3969/j.issn.2095-5340.2022.02.006 |
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| Risk factors for brain injury of premature infants |
| Liu Yanhui, Zhong Qinghua, Shen Jun, et al
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Department of Pediatrics, the First Affiliated Hospital of Kunming Medical University, Yunnan, Kunming 650032, China)
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Abstract 【Abstract】 Objective To investigate the relationship of different types in brain injury (intraventricular
hemorrhage and periventricular leukomalacia ) associated with perinatal factors in preterm infants. Method From June 1st, 2014 to May 31st, 2019, among 473 premature infants with gestational age of 28-33+6 weeks delivered in the Obstetrics Department of the First Affiliated Hospital of Kunming Medical University, 443 live births were admitted to the Neonatal Department. After excluding intractable hypoglycemia, bilirubin encephalopathy, abandonment of treatment and death cases, 392 cases were included. Combined with perinatal history and early clinical manifestations of newborns, the diagnosis of intraventricular hemorrhage and periventricular leukomalacia was based on cranial magnetic resonance imaging. The cases were divided into intraventricular hemorrhage group (102 cases), mild periventricular leukomalacia group (32 cases),moderate and severe periventricular leukomalacia group (31 cases) and no brain injury group (227 cases).Statistical methods were used by χ2 test, t-test and Logistic regression model to analyze the correlation betw different types of brain injury and perinatal factors in preterm infants. Result Among 392 preterm infants ofgestational age from 28-33+6 weeks, the incidence of brain injury was 42.1% (165/392), including 26.0% (102/392)of ventricular hemorrhage and 16.1% (63/392) of periventricular leukomalacia. The Logistic regression modelwas performed. The risk factors for intraventricular hemorrhage were as follows: Severe hypertensive disordersin pregnancy (OR=2.287, 95%CI: 1.099-4.758, P<0.05), bronchopulmonary dysplasia (OR=2.670, 95%CI:1.418-5.029, P<0.01), late-onset sepsis (OR=2.318, 95%CI: 1.234-4.357, P<0.01), mechanical ventilation
](OR=1.936, 95%CI: 1.067-3.517, P<0.05). The risk factors of mild periventricular leukomalacia were clinicalchorioamnionitis (OR=9.864, 95%CI: 2.364-41.155, P< 0.05), neonatal asphyxia (OR= 3.319, 95%CI: 1.394-7.906, P<0.05), pH value of umbilical arterial blood gas analysis <7.00 (OR=4.953, 95%CI: 1.527-13.024,P<0.05). The risk factors of moderate and severe periventricular leukomalacia were severe hypertensivedisorders in pregnancy (OR=4.213, 95%CI: 1.473-12.052, P<0.05) and mechanical ventilation (OR=5.029,95%CI: 1.914-13.193, P<0.05). Conclusions There were different risk factors for different types of brain injuryin preterm infants. Severe hypertensive disorders in pregnancy and mechanical ventilation are common risk factorsfor intraventricular hemorrhage and moderate and severe periventricular leukomalacia, which should be paid high attention.
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Received: 05 February 2021
Published: 31 March 2022
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