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KMID : 1101620190300040229
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Perinatology
2019 Volume.30 No. 4 p.229 ~ p.235
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Risk factors and Effect of Early Hypocarbia on the Development of Cystic Periventricular Leukomalacia in Very Low birth Weight Infants
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Lee Eun-Yi
Yeom Jeong-Mook
Lee Seung-Hyun
So Cheol-Hwan
Oh Yeon-Kyun
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Abstract
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Objective: To evaluate the risk factors and effect of early hypocarbia for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight infants.
Methods: We reviewed medical records of 187 infants with weighting less than 1,500 g who were admitted to the neonatal intensive care unit at Wonkwang University Hospital from January 2012 to December 2016 retrospectively. Twenty five infants died within 28 days of birth. Of the remaining 162 infants, we compared 21 with CPVL group who were detected by cranial ultrasonography and randomly selected 105 infants as 5 times of CPVL were matched for gestational age were enrolled in this study. For statistical analysis, univariate and multivariate analysis of perinatal, maternal, neonatal risk factors and effect of variable early hypocarbia level on development of CPVL were performed.
Results: Incidence of CPVL was 12.96% (21/162). On univariate analysis, intraventricular hemorrhage (≥grade III) (23.8% vs. 6.7%, P=0.0289), culture proven sepsis (19.1% vs. 4.8%, P=0.0417), and hospitalization (days) (73.1±42.1 vs. 57.8±22.4, P=0.0175) and PaCO2 <25 mmHg within 72 hours after birth (66.7% vs. 29.5%, P=0.0022) were associated with CPVL. And multivariate analysis showed culture proven sepsis (odds ratio [OR], 12.399; 95% confidence interval [CI] 1.563?98.348; P=0.017) and PaCO2 <25 mmHg within 72 hours after birth (OR, 8.468; 95% CI 2.150-33.358, P=0.002) were found to be independent risk factors.
Conclusion: Culture proven sepsis and early hypocarbia after birth were important risk factors on development of CPVL.
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KEYWORD
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Cystic periventricular leukomalacia, Risk factors, Hypocapnia, Infant, very low birth weight
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