White matter damage and neurodevelopment in premature infants aged 2 years
Abstract
Objective. To evaluate the patterns of periventricular leukomalacia (PVL) in premature infants with different gestational ages and compare with developmental outcomes in early childhood.
Materials and methods. A retrospective-prospective study included 212 premature babies born between 26 and 37 weeks of gestation. Four groups were formed depending on the gestational age at birth: up to 28 weeks (n = 36); 28—31 weeks (n = 51); 32—33 weeks (n = 55); 34—36 weeks (n = 70). The indices of PVL and long-term periventricular hyperechogenicity (PVHE) in the neonatal period were compared with the outcomes of neurodevelopment.
Results. PVL was significantly more common in prematurity up to 28 weeks — in 50.0 % (18 cases), which is 1.5 times higher compared to the groups of 28—31 weeks and 32—33 weeks, in which similar indicators had approximately the same values (33.3 % and 34.5 %; Fisher’s p < 0.001). cPVL was noted in 7.1 % (5 cases) in newborns with late prematurity (34—36 weeks), which emphasizes the need to consider the risks of developing PVL at birth not only in children under 28 weeks, but also in terms close to full-term. The presence of prolonged PVGE in the neonatal period increases the risk of neurodevelopmental disorders in early life by 2.41 times (RR = 2.41, 95 % CI (1.83;3.19)); Cochrane — Mantel — Haenszel’s p < 0.001) compared to cases without PVHE.
Conclusion. Signs of white matter damage based on neurosonography in the neonatal period were detected in almost every third premature infant (27.8 %). White matter damage affects neurodevelopmental outcomes, which justifies early medical habilitation aimed at reducing the incidence of developmental disorders.
About the Authors
I. Zhаuniaronak
Белорусский государственный медицинский университет
Belarus
Belarus
V. Smychek
Республиканский научно-практический центр медицинской экспертизы и реабилитации
Belarus
Belarus
L. Shalkevich
Белорусский государственный медицинский университет
Belarus
Belarus
O. Shalkevich
Республиканский научно-практический центр «Мать и дитя»
Belarus
Belarus
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Review
For citations:
Zhаuniaronak I., Smychek V., Shalkevich L., Shalkevich O. White matter damage and neurodevelopment in premature infants aged 2 years. Healthcare. 2025;(2):16-23. (In Russ.)
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