Association of Abnormal Findings on Neonatal Cranial Ultrasound With Neurobehavior at Neonatal Intensive Care Unit Discharge in Infants Born Before 30 Weeks’ Gestation

Helderman, Jennifer; Dansereau, Lynne M.; Check, Jennifer; Hofheimer, Julie A.; Smith, Lynne M.; Neal, Charles R.; Carter, Brian S.; Pastyrnak, Steven L.; Betz, Bradford W.; Junewick, Joseph; Borders, Heather; DellaGrotta, Sheri A.; Lester, Barry M.

doi:10.1001/jamanetworkopen.2022.6561

Cited by 9 publications

(8 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been demonstrated that immature fragile microvessels of the germinal matrix in the setting of fluctuations in cerebral blood flow owing to lack of autoregulatory mechanism in this population predispose them to GMH-IVH. GMH-IVH and PHI is almost exclusively immediate post-natal phenomenon with around 50% of events occurring in the first 24 h of life and 90% of events occurring in the first 3 days of life [6,[15][16][17][18][19]. The chances of hemorrhage drastically reduce after the first week of post-natal life presumably due to increased tissue oxygenation after birth which suppresses vascular endothelial growth factor and angiopoietin-2 thus reducing the formation of fragile new vessels [15].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of role of cranial ultrasound (CUS) in the evaluation of high-risk preterm and term neonates

Sherwani

Parry

Bhat

et al. 2023

Egypt Pediatric Association Gaz

View full text Add to dashboard Cite

Background Cranial ultrasonography (CUS) has become an important tool to depict normal brain anatomy and to detect the ischemic and hemorrhagic brain injury patterns in high-risk neonates. The present study aimed to assess the utility of CUS to diagnose the spectrum of brain injury patterns in high-risk preterm and term neonates admitted to the neonatal intensive care unit (NICU) and to find the association of CUS findings in various adverse antenatal and perinatal feto-maternal factors. Results Out of the 200 neonates, 76 (38%) neonates had abnormal CUS findings and 124 (62%) had a normal CUS. Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) (28/76; 36.8 %) was the commonest abnormality with GMH (grade 1) in 14/76 (18.4%), grade 2 in 7 (9.2%), grade 3 in 5 (6.5%), and grade 4 in 2 (2.63%). The other findings observed were cerebral edema (14/76; 18.4%), thalamic hyperechogenicity (10/76; 13.1%), periventricular leukomalacia (PVL) (4/76; 5.2%), and congenital anomalies (8; 10.5%). Abnormal CUS findings had a statistically significant association with birth weight <2000 g, prematurity, Apgar score <7, and adverse peri-natal fetal and maternal factors (all p-values <0.05). Abnormal CUS findings had a statistically significant association with poor cry, poor activity, abnormal tone, and presence of cyanosis (all p-values <0.05). Conclusion In this cohort study of high-risk preterm and term infants GMH-IVH, cerebral edema, thalamic hyperechogenicity, PVL, and congenital malformations were the commonest lesions detected on CUS. Abnormal CUS findings were found to have a statistically significant association with various adverse peri-natal fetal and maternal factors.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Ventriculomegaly had the highest RR for delayed psychomotor development (RR: 4.40), followed by PVHI (RR: 3.90), echolucency (RR: 3.70), and cystic PVL (RR: 3.60) [12]. In a recent study of preterm infants, early CUS lesions were associated with poor attention, hypotonicity, and poor quality of movement at term-equivalent age [17].…”

mentioning

confidence: 97%

Assessment of role of cranial ultrasound (CUS) in the evaluation of high-risk preterm and term neonates

Sherwani

Parry

Bhat

et al. 2023

Egypt Pediatric Association Gaz

View full text Add to dashboard Cite

show abstract

“…The major findings from NOVI, thus far, relate to associations between infant atypical neurobehavior and specific medical problems such as infant sepsis 9 and brain injury. 10 These infants also displayed unique epigenetic changes 11 and were born to mothers with adverse medical and psychosocial conditions. 12 Longitudinal collection of buccal cells, which has provided insight into DNA methylation changes related to neurobehavior and medical health, 12 – 14 will allow for deeper understanding of epigenetic changes over time.…”

Section: Cohorts Of Individuals Born Very Pretermmentioning

confidence: 99%

Environmental influences on child health outcomes: cohorts of individuals born very preterm

et al. 2022

Self Cite

View full text Add to dashboard Cite

The National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) Program was designed to address solution-oriented research questions about the links between children’s early life environment and their risks of pre-, peri-, and post-natal complications, asthma, obesity, neurodevelopmental disorders, and positive health. Children born very preterm are at increased risk for many of the outcomes on which ECHO focuses, but the contributions of environmental factors to this risk are not well characterized. Three ECHO cohorts consist almost exclusively of individuals born very preterm. Data provided to ECHO from cohorts can be used to address hypotheses about (1) differential risks of chronic health and developmental conditions between individuals born very preterm and those born at term; (2) health disparities across social determinants of health; and (3) mechanisms linking early-life exposures and later-life outcomes among individuals born very preterm. Impact The National Institutes of Health’s Environmental Influences on Child Health Outcomes Program is conducting solution-oriented research on the links between children’s environment and health. Three ECHO cohorts comprise study participants born very preterm; these cohorts have enrolled, to date, 1751 individuals born in 14 states in the U.S. in between April 2002 and March 2020. Extensive data are available on early-life environmental exposures and child outcomes related to neurodevelopment, asthma, obesity, and positive health. Data from ECHO preterm cohorts can be used to address questions about the combined effects of preterm birth and environmental exposures on child health outcomes.

show abstract

“…Among these complications are forms of perinatal brain injury such as intraventricular hemorrhage (IVH), parenchymal lesions that reflect focal ischemic or hemorrhagic injury to white matter, and ventricular enlargement that are detectable with neonatal cranial ultrasound (CUS) [ 7 ]. Although magnetic resonance imaging (MRI) is more sensitive than CUS for detecting white matter damage, CUS is safer, more efficient, and significantly less expensive than MRI [ 8 ]. The specific brain abnormalities on routine CUS in low gestational age infants are associated with cerebral palsy and other neurodevelopmental impairments [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Autism Spectrum Disorder Risk in Infants With Intraventricular Hemorrhage

Shehzad,

Raju,

Jackson

et al. 2023

Cureus

View full text Add to dashboard Cite

Background This study evaluates the long-term risk of autism spectrum disorder (ASD) in infants with intraventricular hemorrhage (IVH) using the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F) screening tool. Methods This retrospective cohort study compared IVH (exposed) infants across all gestational age groups with no-IVH (non-exposed) infants admitted to level IV neonatal intensive care unit (NICU). The M-CHAT-R/F screening tool was used to assess the ASD risk at 16-30 months of age. Discharge cranial ultrasound (CUS) findings also determined the ASD risk. Descriptive statistics comprised median and interquartile range for skewed continuous data and frequencies and percentages for categorical variables. Comparisons for non-ordinal categorical measures in bivariate analysis were carried out using the χ 2 test or Fisher exact test. Results Of the 334 infants, 167 had IVH, and 167 had no IVH. High ASD risk (43% vs. 20%, p = 0.044) and cerebral palsy (19% vs. 5%, p = 0.004) were significantly associated with severe IVH. Infants with CUS findings of periventricular leukomalacia had 3.24 odds of developing high ASD risk (odds ratios/OR: 3.24, 95% confidence interval/CI: 0.73-14.34), and those with hydrocephalus needing ventriculoperitoneal (VP) shunt had 4.75 odds of developing high ASD risk (OR: 4.75, 95% CI: 0.73-30.69). Conclusion Severe IVH, but not mild IVH, increased the risk of ASD and cerebral palsy. This study demonstrates the need for timely screening for ASD in high-risk infants. Prompt detection leads to earlier treatment and better outcomes.

show abstract

Association of Abnormal Findings on Neonatal Cranial Ultrasound With Neurobehavior at Neonatal Intensive Care Unit Discharge in Infants Born Before 30 Weeks’ Gestation

Cited by 9 publications

References 42 publications

Assessment of role of cranial ultrasound (CUS) in the evaluation of high-risk preterm and term neonates

Assessment of role of cranial ultrasound (CUS) in the evaluation of high-risk preterm and term neonates

Environmental influences on child health outcomes: cohorts of individuals born very preterm

Evaluation of Autism Spectrum Disorder Risk in Infants With Intraventricular Hemorrhage

Contact Info

Product

Resources

About