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Oltean I, Rajaram A, Tang K, MacPherson J, Hondonga T, Rishi A, Toltesi R, Gowans R, Jahangirnia A, Nasr Y, Lawrence SL, El Demellawy D. The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis. J Clin Med 2022; 12:jcm12010205. [PMID: 36615006 PMCID: PMC9821447 DOI: 10.3390/jcm12010205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/17/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Placental histopathology provides insights, or "snapshots", into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption versus without abruption. Records were sourced from MEDLINE, Embase, and the CENTRAL Trials Registry from 1946 to December 2019. Studies followed the PRISMA guidelines and compared frequencies of neurodevelopmental morbidities in infants born to pregnant women with placental abruption (exposure) versus women without placental abruption (comparator). The primary endpoint was cerebral palsy. Periventricular and intraventricular (both severe and any grades of IVH) and any histopathological neuronal damage were the secondary endpoints. Study methodologic quality was assessed by the Ottawa-Newcastle scale. Estimated odds ratios (OR) and hazards ratio (HR) were derived according to study design. Data were meta-analyzed using a random effects model expressed as pooled effect sizes and 95% confidence intervals. We included eight observational studies in the review, including 1245 infants born to women with placental abruption. Results of the random effects meta-analysis show that the odds of infants born to pregnant women with placental abruption who experience cerebral palsy is higher than in infants born to pregnant women without placental abruption (OR 5.71 95% CI (1.17, 27.91); I2 = 84.0%). There is no statistical difference in the odds of infants born to pregnant women with placental abruption who experience severe IVH (grade 3+) (OR 1.20 95% CI (0.46, 3.11); I2 = 35.8%) and any grade of IVH (OR 1.20 95% CI (0.62, 2.32); I2 = 32.3%) vs. women without placental abruption. There is no statistically significant difference in the odds of infants born to pregnant women with placental abruption who experience PVL vs. pregnant women without placental abruption (OR 6.51 95% CI (0.94, 45.16); I2 = 0.0%). Despite our meta-analysis suggesting increased odds of cerebral palsy in infants born to pregnant women with placental abruption versus without abruption, this finding should be interpreted cautiously, given high heterogeneity and overall poor quality of the included studies.
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Affiliation(s)
- Irina Oltean
- Department of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; (I.O.); (K.T.)
| | - Ajay Rajaram
- Department of Pathology, McGill University, Montreal, QC H4A 3J1, Canada;
| | - Ken Tang
- Department of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; (I.O.); (K.T.)
| | - James MacPherson
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (J.M.); (Y.N.)
| | | | - Aanchal Rishi
- Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada;
| | - Regan Toltesi
- Faculty of Science, Engineering and Architecture, Laurentian University, Sudbury, ON P3E 2C6, Canada;
| | - Rachel Gowans
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Ashkan Jahangirnia
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
| | - Youssef Nasr
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (J.M.); (Y.N.)
| | - Sarah L. Lawrence
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
- Division of Neonatology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
- Correspondence: ; Tel.: +1-613-737-7600
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Gaynetdinova DD, Karimova LK, Kazakova FM, Gamirova RG. Risk factors, trends of neurological disorders, and outcomes of neonatal periventricular hemorrhages. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2022. [DOI: 10.21508/1027-4065-2022-67-5-143-152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Periventricular hemorrhage is bleeding from the subependymal germinal matrix, which results in severe motor disorders, mental and speech developmental delay.Purpose. The study aims to evaluate risk factors, the trends of neurological disorders, and the outcomes of neonatal periventricular hemorrhage in children whose mothers were on gravidary anticoagulant and/or antiplatelet therapy.Material and methods. The study examined 160 newborns with PVH: Group I — 53 (37.9%) children born from pregnancy on the background of antiplatelet and/or anticoagulant therapy for hypercoagulation syndrome; Group II — 87 (62.1%) children born from pregnancy on the background of antiplatelet and/or anticoagulant therapy to treat degree 1A uteroplacental blood flow disorders; Group III — 20 children born from pregnancy without corticosteroids and antiplatelet and/or anticoagulant therapy. All newborns underwent clinical and neurological examination and neurosonography; data on somatic and obstetric anamnesis were obtained from accompanying medical records.Results. In children of Groups I and II a more severe condition of newborns with periventricular hemorrhage at birth was noted, a slower dynamics of restoration of muscle-postural tone and the pace of psychomotor development were observed compared to children in Group III. In Groups I and II a high incidence of epilepsy (5.7%) and cerebral palsy (6.4%) by 12 months of corrected age was revealed compared with the population.Conclusion. Gravidary anticoagulant and antiplatelet therapy might be considered as a risk factor for the development of intracranial hemorrhages and severe neurological disorders: epilepsy, cerebral palsy, mental and motor developmental delays.
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Siffel C, Kistler KD, Sarda SP. Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review. J Perinat Med 2021; 49:1017-1026. [PMID: 33735943 DOI: 10.1515/jpm-2020-0331] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/16/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To conduct a systematic literature review to evaluate the global incidence of intraventricular hemorrhage grade 2-4 among extremely preterm infants. METHODS We performed searches in MEDLINE and Embase for intraventricular hemorrhage and prematurity cited in English language observational studies published from May 2006 to October 2017. Included studies analyzed data from infants born at ≤28 weeks' gestational age and reported on intraventricular hemorrhage epidemiology. RESULTS Ninety-eight eligible studies encompassed 39 articles from Europe, 31 from North America, 25 from Asia, five from Oceania, and none from Africa or South America; both Europe and North America were included in two publications. The reported global incidence range of intraventricular hemorrhage grade 3-4 was 5-52% (Europe: 5-52%; North America: 8-22%; Asia: 5-36%; Oceania: 8-13%). When only population-based studies were included, the incidence range of intraventricular hemorrhage grade 3-4 was 6-22%. The incidence range of intraventricular hemorrhage grade 2 was infrequently documented and ranged from 5-19% (including population-based studies). The incidence of intraventricular hemorrhage was generally inversely related to gestational age. CONCLUSIONS Intraventricular hemorrhage is a frequent complication of extremely preterm birth. Intraventricular hemorrhage incidence range varies by region, and the global incidence of intraventricular hemorrhage grade 2 is not well documented.
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Affiliation(s)
- Csaba Siffel
- Global Evidence and Outcomes, Takeda, Lexington, MA, USA.,College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Kristin D Kistler
- Evidence Synthesis, Modeling & Communication, Evidera, Waltham, MA, USA
| | - Sujata P Sarda
- Global Evidence and Outcomes, Takeda, Lexington, MA, USA
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Abiramalatha T, Bandyopadhyay T, Ramaswamy VV, Shaik NB, Thanigainathan S, Pullattayil AK, Amboiram P. Risk Factors for Periventricular Leukomalacia in Preterm Infants: A Systematic Review, Meta-analysis, and GRADE-Based Assessment of Certainty of Evidence. Pediatr Neurol 2021; 124:51-71. [PMID: 34537463 DOI: 10.1016/j.pediatrneurol.2021.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/20/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND We analyzed the certainty of evidence (CoE) for risk factors of periventricular leukomalacia (PVL) in preterm neonates, a common morbidity of prematurity. METHODS Medline, CENTRAL, Embase, and CINAHL were searched. Cohort and case-control studies and randomised randomized controlled trials were included. Data extraction was performed in duplicate. A random random-effects meta-analysis was utilizedused. CoE was evaluated as per Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS One hundred eighty-six studies evaluating 95 risk factors for PVL were included. Of the 2,509,507 neonates assessed, 16,569 were diagnosed with PVL. Intraventricular hemorrhage [adjusted odds ratio: 3.22 (2.52-4.12)] had moderate CoE for its association with PVL. Other factors such as hypocarbia, chorioamnionitis, PPROM >48 hour, multifetal pregnancy reduction, antenatal indomethacin, lack of antenatal steroids, perinatal asphyxia, ventilation, shock/hypotension, patent ductus arteriosus requiring surgical ligation, late-onset circulatory collapse, sepsis, necrotizing enterocolitis, and neonatal surgery showed significant association with PVL after adjustment for confounders (CoE: very low to low). Amongst the risk factors associated with mother placental fetal (MPF) triad, there was paucity of literature related to genetic predisposition and defective placentation. Sensitivity analysis revealed that the strength of association between invasive ventilation and PVL decreased over time (P < 0.01), suggesting progress in ventilation strategies. Limited studies had evaluated diffuse PVL. CONCLUSION Despite decades of research, our findings indicate that the CoE is low to very low for most of the commonly attributed risk factors of PVL. Future studies should evaluate genetic predisposition and defective placentation in the MPF triad contributing to PVL. Studies evaluating exclusively diffuse PVL are warranted.
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Affiliation(s)
- Thangaraj Abiramalatha
- Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research, New Delhi, India
| | | | - Nasreen Banu Shaik
- Department of Neonatology, Ankura Hospital for Women and Children, Hyderabad, India
| | - Sivam Thanigainathan
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Prakash Amboiram
- Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Mesenchymal stem cell-derived secretomes for therapeutic potential of premature infant diseases. Biosci Rep 2021; 40:222738. [PMID: 32320046 PMCID: PMC7953482 DOI: 10.1042/bsr20200241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
Preterm birth is a complex syndrome and remains a substantial public health problem globally. Its common complications include periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). Despite great advances in the comprehension of the pathogenesis and improvements in neonatal intensive care and associated medicine, preterm birth-related diseases remain essentially without adequate treatment and can lead to high morbidity and mortality. The therapeutic potential of mesenchymal stem/stromal cells (MSCs) appears promising as evidenced by their efficacy in preclinical models of pathologies relevant to premature infant complications. MSC-based therapeutic efficacy is closely associated with MSC secretomes and a subsequent paracrine action response to tissue injuries, which are complex and abundant in response to the local microenvironment. In the current review, we summarize the paracrine mechanisms of MSC secretomes underlying diverse preterm birth-related diseases, including PVL, BPD, NEC and ROP, are summarized, and focus is placed on MSC-conditioned media (CM) and MSC-derived extracellular vesicles (EVs) as key mediators of modulatory action, thereby providing new insights for future therapies in newborn medicine.
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Boswinkel V, Nijboer-Oosterveld J, Nijholt IM, Edens MA, Mulder-de Tollenaer SM, Boomsma MF, de Vries LS, van Wezel-Meijler G. A systematic review on brain injury and altered brain development in moderate-late preterm infants. Early Hum Dev 2020; 148:105094. [PMID: 32711341 DOI: 10.1016/j.earlhumdev.2020.105094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To provide a systematic review of brain injury and altered brain development in moderate-late preterm (MLPT) infants as compared to very preterm and term infants. STUDY DESIGN A systematic search in five databases was performed in January 2020. Original research papers on incidence of brain injury and papers using quantitative data on brain development in MLPT infants were selected. The Johanna Briggs Institute 'Critical Appraisal Checklist for Studies Reporting Prevalence Data' was used for quality appraisal. Data extraction included: imaging modality, incidences of brain injury, brain volumes, 2D-measurements and diffusivity values. RESULTS In total, 24 studies were eligible. Most studies had a moderate quality. Twenty studies reported on the incidence of brain injury in MLPT infants. The incidence of intraventricular hemorrhage (IVH) ranged from 0.0% to 23.5% and of white matter injury (WMI) from 0.5% to 10.8%. One study reported the incidence of arterial infarction (0.3%) and none of cerebellar hemorrhage. Eleven studies compared incidences of brain injury between MLPT infants and very preterm or term infants. Five studies reported signs of altered brain development in MLPT infants. CONCLUSIONS The incidences of IVH and WMI in MLPT infants varied widely between studies. Other abnormalities were sparsely reported. Evidence regarding a higher or lower incidence of brain injury in MLPT infants compared to very preterm or term infants is weak due to moderate methodological quality of reported studies. There is limited evidence suggesting a difference in brain development between MLPT and term infants.
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Affiliation(s)
- Vivian Boswinkel
- Department of Neonatology, Isala Women and Children's hospital, Zwolle, the Netherlands; University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| | | | - Ingrid M Nijholt
- Department of Radiology, Isala hospital, Zwolle, the Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala hospital, Zwolle, the Netherlands
| | | | | | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
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Chung Y, Cho H, Jo GH, Jun Y. Hypoxia of Rats Subjected to Carotid Artery Ligation Results in Impaired Neurogenesis and Reduced Number of Cortical Neurons. In Vivo 2019; 33:441-445. [PMID: 30804123 DOI: 10.21873/invivo.11492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIM Cerebral ischemia is a major cause of abnormal brain development. In a cerebral ischemia model, periventricular leukomalacia (PVL), white matter lesion and a decrease in the number of subcortical neurons were observed. The aim of this study was to investigate the effect of hypoxia on neurogenesis and cell survival. MATERIALS AND METHODS In seven-day postnatal rats, the right carotid artery was ligated. The rats were incubated either in a regular normoxic chamber (control group) or in a hypoxic chamber (PVL group, 8% 02 and 92% N2 at 37°C) for 2 h. Nestin- and NeuN-positive neurons were detected by immunohistochemistry. RESULTS The densities of nestin-immunoreactivity (IR) cells in the cerebral parietal cortex and subventricular zone were increased with hypoxia. NeuN-IR cells in the cerebral cortex were significantly decreased in the PVL group. CONCLUSION Perinatal white matter injury induced neurogenesis, while the survival of neurons was decreased in the cerebral cortex.
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Affiliation(s)
- Yoonyoung Chung
- Department of Anatomy, School of Medicine, Chosun University, Gwang-ju, Republic of Korea
| | - Hanbit Cho
- School of Medicine, Chosun University, Gwang-ju, Republic of Korea
| | - Gyeong Hyeon Jo
- School of Medicine, Chosun University, Gwang-ju, Republic of Korea
| | - Yonghyun Jun
- Department of Anatomy, School of Medicine, Chosun University, Gwang-ju, Republic of Korea
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Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol 2017; 34:935-957. [PMID: 28329897 PMCID: PMC5683164 DOI: 10.1055/s-0037-1599149] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption. Results A total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy. Conclusion Few studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.
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Affiliation(s)
- Katheryne L. Downes
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Obstetrics and Gynecology, Center for Research in Reproduction and Women’s Health, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katherine L. Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Edmond D. Shenassa
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, Maryland
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Zhu L, Huang L, Wen Q, Wang T, Qiao L, Jiang L. Recombinant human erythropoietin offers neuroprotection through inducing endogenous erythropoietin receptor and neuroglobin in a neonatal rat model of periventricular white matter damage. Neurosci Lett 2017; 650:12-17. [PMID: 28359933 DOI: 10.1016/j.neulet.2017.03.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/10/2017] [Accepted: 03/15/2017] [Indexed: 01/25/2023]
Abstract
Recombinant human erythropoietin (rh-EPO) has been reported to have protective effects against brain injury. The purpose of this study was to evaluate the levels of erythropoietin receptor (EPOR) and neuroglobin (Ngb) in a neonatal rat model of periventricular white matter damage (PWMD), and to identify the relationship between the two proteins. On postnatal day 3 (P3), rats underwent permanent ligation of the right common carotid artery followed by 6% O2 for 4h (HI) or sham operation and normoxic exposure (sham). Immediately after HI, rats received a single intraperitoneal injection of rh-EPO (5U/g) or saline. We assessed the expression level of Ngb and EPOR on postnatal days 5, 7, 10 and 14. EPOR in the HI rats was initially increased as compared to the sham rats at P5. Subsequently, EPOR expression decreased, but was maintained at a higher level than in sham rats from P7 to P14. In rh-EPO treated rats, the increase in EPOR was greater than in HI rats at P5. However, EPOR levels decreased sharply from P7 to P14. In HI rats, Ngb was increased compared to the sham rats from P5 to P14. Ngb levels were further upregulated after rh-EPO administration from P5 to P10 compared to HI rats. However, this upregulation decreased at P14. In conclusion, this study shows that EPOR and Ngb were upregulated, and both of them act as important coordinated neuroprotectors in rh-EPO treatment of PWMD. However, the two proteins exhibit different expression patterns.
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Affiliation(s)
- Lihua Zhu
- Institute of Clinical and Nursing, Jiangsu Jiankang Vocational College, 69 Huangshan Ling Road, Pukou District, Nanjing 211800, Jiangsu, China
| | - Li Huang
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjia Qiao, Gulou District, Nanjing 210009, Jiangsu, China
| | - Quan Wen
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjia Qiao, Gulou District, Nanjing 210009, Jiangsu, China
| | - Ting Wang
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipai Lou, Xuanwu District, Nanjing 210096, Jiangsu, China
| | - Lixing Qiao
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjia Qiao, Gulou District, Nanjing 210009, Jiangsu, China.
| | - Li Jiang
- Department of Pediatrics, Zhongda Hospital, Southeast University, 87 Dingjia Qiao, Gulou District, Nanjing 210009, Jiangsu, China.
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Lu H, Wang Q, Lu J, Zhang Q, Kumar P. Risk Factors for Intraventricular Hemorrhage in Preterm Infants Born at 34 Weeks of Gestation or Less Following Preterm Premature Rupture of Membranes. J Stroke Cerebrovasc Dis 2016; 25:807-12. [PMID: 26796051 DOI: 10.1016/j.jstrokecerebrovasdis.2015.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/22/2015] [Accepted: 12/10/2015] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE The objective of this study is to identify possible perinatal risk factors related to intraventricular hemorrhage (IVH) in preterm infants born at 34 weeks of gestation or less following preterm premature rupture of membranes (pPROM). METHODS A total of 292 preterm infants born at 34 weeks of gestation or less following pPROM were enrolled in the study, while 155 newborns with incomplete data, especially those that lack histological examination of the placenta, maternal details, and neonatal characteristics, have been further excluded. Finally, data of 137 preterm infants were included in the analysis. All infants underwent ultrasonographic screening for IVH. Thirty-three infants with IVH were considered as cases and 104 infants without IVH were considered as controls. The association between risk factors and IVH was evaluated by univariate and multivariate logistic regression analyses. RESULTS The incidence of IVH in preterm infants born at 34 weeks of gestation or less following pPROM was 24.1%, while the incidence of maternal chorioamnionitis was 43.8%. By univariate analysis, gestational age, birth weight, asphyxia resuscitation, maternal chorioamnionitis, fetal distress, amniotic fluid index, and latency of the rupture of membranes to birth were found to be significantly different between the 2 groups. By logistic regression analysis, lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis were found to be independent risk factors for IVH. CONCLUSION Lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis are independent risk factors for IVH in preterm infants born at 34 weeks of gestation or less following pPROM.
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Affiliation(s)
- Hongyan Lu
- Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China.
| | - Qiuxia Wang
- Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Junyin Lu
- Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Qiang Zhang
- Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Pravesh Kumar
- Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China
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Zhu LH, Bai X, Zhang N, Wang SY, Li W, Jiang L. Improvement of human umbilical cord mesenchymal stem cell transplantation on glial cell and behavioral function in a neonatal model of periventricular white matter damage. Brain Res 2014; 1563:13-21. [DOI: 10.1016/j.brainres.2014.03.030] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/06/2014] [Accepted: 03/19/2014] [Indexed: 01/11/2023]
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