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‘‘Intraventricular’’ Hemorrhage and Cystic Periventricular Leukomalacia in Preterm Infants: How Are They Related?

Department of Epidemiology and Biostatistics, Radboud University, Nijmegen, The Netherlands, cynthiakusters{at}gmail.com, Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts

Minghua L. Chen, MD, MPH

Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts

Pamela L. Follett, MD

Pediatric Neurology, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts

Olaf Dammann, MD, SM

Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, Perinatal Neuroepidemiology Unit, Hannover Medical School, Hannover, Germany, Neuroepidemiology Unit, Children's Hospital, Boston, Massachusetts

Intraventricular hemorrhage and cystic periventricular leukomalacia are often co-occurring characteristics of brain damage in preterm infants. Using data from 1016 infants born before 30 completed weeks’ gestational age, we sought to clarify the relationship between severe intraventricular hemorrhage and cystic periventricular leukomalacia, with special emphasis on common antecedents and potential confounding. After comparing risk factors for intraventricular hemorrhage grades 1 through 4 and cystic periventricular leukomalacia, it appears the risk patterns for intraventricular hemorrhage grade 3, intraventricular hemorrhage grade 4, and cystic periventricular leukomalacia differ. The association between intraventricular hemorrhage grade 3 and cystic periventricular leukomalacia differs appreciably from the association between intraventricular hemorrhage grade 4 and cystic periventricular leukomalacia, supporting the notion that intraventricular hemorrhage grade 3 and intraventricular hemorrhage grade 4 are different entities. The presence of intraventricular hemorrhage grade 3 and intraventricular hemorrhage grade 4 increases the risk of cystic periventricular leukomalacia, even after adjusting for potential confounders. This raises the possibility that intraventricular hemorrhage grade 3 and intraventricular hemorrhage grade 4 cause cystic periventricular leukomalacia.

Key Words: preterm • intraventricular hemorrhage • cystic periventricular leukomalacia • risk pattern • association

Journal of Child Neurology, Vol. 24, No. 9, 1158-1170 (2009)
DOI: 10.1177/0883073809338064


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