Periventricular echodensities (PVED) is a finding in head ultrasound (HUS) of preterm infants that can develop into cystic lesions. In these cases, it is associated with significant neurological morbidity, such as cerebral palsy. However, in most cases, PVED is transient, and its significance is controversial. Information regarding risk factors for PVED is lacking.
Our objectives were to identify risk factors for PVED in preterm infants, and to evaluate associated neonatal morbidity. We enrolled in a case-control study, all 208 preterm infants of gestational age ≤ 34 weeks born at the Sheba medical center between 1.1.2008-1.11.2013, which had PVED described in one of their screening HUS sessions, with no additional pathology. A preterm infant of similar gestational age and approximate birth date, who had normal HUS screening, was matched to each case and served as a control.
No significant differences were found between cases and controls in regards to all the examined parameters, including maternal and delivery data, as well as neonatal parameters and complications. In a second analysis, the PVED group was subdivided according to the timing in which this finding was observed. PVED was observed in 22(16.2%) of 136 cases who underwent HUS screening at the age of 1 month. PVED at 1 month was predicted by maternal treatment with magnesium sulfate (OR=2.8 [CI 1.143-6.907] p=0.024) and 5-min Apgar score
We conclude that maternal treatment with magnesium sulfate and 5-min Apgar score<7, seem to be risk factors for PVED at the age of 1 month. Moreover, these preterm infants seem to be at risk for additional neonatal morbidity during their hospitalization in the NICU. Further studies are needed to establish the risk factors for prolonged PVED and its clinical significance.
