TY - JOUR
T1 - Cranial ultrasonography and transfontanellar Doppler in premature neonates (24-32 weeks of gestation)
T2 - Dynamic evolution and association with a severe adverse neurological outcome at hospital discharge in the Aquitaine cohort, 2003-2005
AU - Brissaud, Olivier
AU - Boufkhed, Sabah
AU - Joly, Laurence
AU - Germain, Christine
AU - Bouvet-Murcia, Agnes
AU - Brun, Muriel
AU - Chateil, Jean-Francois
AU - Leroy, Valeriane
AU - Grp, Aquipage Study
PY - 2012/9/1
Y1 - 2012/9/1
N2 - Objective: To correlate the short-term neurological outcome of early cerebral abnormalities using cranial ultrasonography (US) in premature newborns at their hospital discharge. Methods: Each newborn born = one morphologic abnormality (moderate: intra-ventricular hemorrhage (IVH) grades 1-2; severe: IVH 3-4, periventricular leukomalacia, persistent flares). Correlates of having a severe adverse neurological outcome were analyzed using a stepwise backward logistic regression adjusted model with gestational age, early cerebral abnormality at Days 3-8, velocity and with variables with correlation probabilities with p <0.25 in the univariate analysis among occurring comorbidity events previously defined. Two adjusted logistic regression analyses were conducted including or not velocity data because of missing information. Results: Among 452 premature included, 11.3% did not have an early US, 74.8% had a normal early US, 13.9% >= one early morphological US abnormality (10.0% moderate, 3.9% severe). At hospital discharge, 40% were still alive with a normal late US, 33% alive with >= one late morphological US abnormality (10% moderate, 23% severe), and 10% died. Adjusted correlates of a late US severe abnormality or a neurological related death at hospital discharge were: early US abnormality (aOR: 8.7, 95% CI: 2.3-33.6), GA<29 weeks (aOR: 2.8 95% CI: 1.4-5.4). Conclusion: This study shows that early US morphological abnormalities increase significantly when the GA decreases and is highly predictive of the occurrence of a further late US severe abnormality or neurological related death at hospital discharge. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
AB - Objective: To correlate the short-term neurological outcome of early cerebral abnormalities using cranial ultrasonography (US) in premature newborns at their hospital discharge. Methods: Each newborn born = one morphologic abnormality (moderate: intra-ventricular hemorrhage (IVH) grades 1-2; severe: IVH 3-4, periventricular leukomalacia, persistent flares). Correlates of having a severe adverse neurological outcome were analyzed using a stepwise backward logistic regression adjusted model with gestational age, early cerebral abnormality at Days 3-8, velocity and with variables with correlation probabilities with p <0.25 in the univariate analysis among occurring comorbidity events previously defined. Two adjusted logistic regression analyses were conducted including or not velocity data because of missing information. Results: Among 452 premature included, 11.3% did not have an early US, 74.8% had a normal early US, 13.9% >= one early morphological US abnormality (10.0% moderate, 3.9% severe). At hospital discharge, 40% were still alive with a normal late US, 33% alive with >= one late morphological US abnormality (10% moderate, 23% severe), and 10% died. Adjusted correlates of a late US severe abnormality or a neurological related death at hospital discharge were: early US abnormality (aOR: 8.7, 95% CI: 2.3-33.6), GA<29 weeks (aOR: 2.8 95% CI: 1.4-5.4). Conclusion: This study shows that early US morphological abnormalities increase significantly when the GA decreases and is highly predictive of the occurrence of a further late US severe abnormality or neurological related death at hospital discharge. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
U2 - 10.1016/j.ejrad.2011.11.017
DO - 10.1016/j.ejrad.2011.11.017
M3 - Article
SN - 0720-048X
VL - 81
SP - 2396
EP - 2402
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 9
ER -