A population-based study of cystic white matter injury on ultrasound in very preterm infants born over two decades in Nova Scotia, Canada

• Published in: Journal of perinatology Vol. 39; no. 2; pp. 269 - 277
• Main Authors: Ghotra, Satvinder, Vincer, Michael, Allen, Victoria M., Khan, Naeem
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.02.2019; Nature Publishing Group
• Subjects: 631/378; 692/699/375/1345; Analysis; Canada; Central Nervous System Cysts - diagnostic imaging; Central Nervous System Cysts - epidemiology; Cerebral palsy; Cerebral Palsy - diagnostic imaging; Cerebral Palsy - epidemiology; Chorioamnionitis; Coagulase; Developmental disabilities; Disabilities; Female; Gestational Age; Health aspects; Health risk assessment; Health risks; Humans; Hypothermia; Infant; Infant, Extremely Premature; Infant, Newborn; Infants; Infection; Logistic Models; Male; Medicine; Medicine & Public Health; Mortality; Multivariate Analysis; Mycoses; Neonates; Newborn babies; Nova Scotia; Nova Scotia - epidemiology; Paralysis; Parenting; Pediatric Surgery; Pediatrics; Population studies; Population-based studies; Prejudice; Premature babies; Premature birth; Premature infants; Retrospective Studies; Risk analysis; Risk factors; Staphylococcal infections; Steroid hormones; Steroids; Substantia alba; Time; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Waste management industry; White Matter - pathology; Nova Scotia; Canada; Nova Scotia Canada
• ISSN: 0743-8346; 1476-5543; 1476-5543
• DOI: 10.1038/s41372-018-0294-5

Objective To identify the temporal trends, risk factors and outcomes of cystic white matter injury (WMI) detected by ultrasound in a population-based cohort of very preterm infants (VPI) with a minimal risk of selection bias. Study design All live-born VPIs between 22 and < 31 weeks gestational age born in Nova Scotia, Canada from 1993 to 2013. Results Cystic WMI was identified in 87 (7%) out of 1184 eligible infants. The gestational age and mortality adjusted prevalence of cystic WMI decreased over time ( p  = 0.04). In multivariable analysis, chorioamnionitis, antenatal steroids, admission hypothermia, ventilator support, inotropes, and non-Coagulase-negative Staphylococcal and fungal infections were independently associated with cystic WMI. Cerebral palsy was the most common disability in the survivors, however, half of the survivors had none or mild disability. Conclusions This cohort study demonstrated a decreasing trend in the incidence of cystic WMI and reported population-based neurological outcomes with cystic WMI, which is important for health-care planning and parental counseling.