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Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants
Author(s) -
Spinillo Arsenio,
Chiara Alberto,
Bergante Carola,
Biancheri Danila,
Fabiana DePaoli,
Fazzi Elisa
Publication year - 2004
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00229.x
Subject(s) - medicine , echogenicity , logistic regression , obstetrics , pregnancy , odds ratio , dexamethasone , gestation , parenchyma , pediatrics , gestational age , ultrasound , radiology , pathology , genetics , biology
Objective To assess the risk of persistent (>7 days) increases in brain parenchymal echogenicity in preterm infants and their association with known obstetric risk factors. Design Case–control study of prospectively collected data. Setting A University hospital in Northern Italy. Population Eighty‐five singleton infants between 24 and 34 weeks of gestation with a cranial ultrasonographic diagnosis of persistently increased parenchymal echogenicity without development of cystic degeneration, and 170 control infants with negative cranial ultrasonographic findings. Methods A comparison of the prevalence of selected obstetric risk factors between infants with persistent echo‐dense lesions and negative controls. Main outcome measures Odds ratios of persistent echo‐dense lesions including first‐degree interactions between variables. Results After adjusting for birthweight, logistic regression analysis showed that the only factor associated with an increased risk of persistent brain echo‐dense lesions in infants was multiple courses of antenatal steroids (OR = 2.14, 95% CI = 1.11–4.15, P = 0.024). In this group, the risk of persistent echo‐dense lesions was particularly high in: (i) mothers receiving dexamethasone rather than betamethasone ( P value for interaction = 0.015) and (ii) after expectant management of pre‐eclampsia or intrauterine growth retardation ( P value for interaction = 0.03). Conclusions Multiple doses of antenatal steroids, especially dexamethasone, could influence the prevalence of persistent increases in brain parenchymal echogenicity in preterm infants.