Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants
Article first published online: 9 JUL 2004
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 111, Issue 9, pages 913–918, September 2004
How to Cite
Spinillo, A., Chiara, A., Bergante, C., Biancheri, D., Fabiana, D. and Fazzi, E. (2004), Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 913–918. doi: 10.1111/j.1471-0528.2004.00229.x
- Issue published online: 23 AUG 2004
- Article first published online: 9 JUL 2004
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.