Incidence and Risk Factors for Cystic Periventricular Leukomalacia in Premature Low Birth Weight Infants

Purpose : While the survival rate of preterm infants in the neonatal intensive care unit is increasing, the neurological complication such as cerebral palsy is still a serious problem. This study is to determine the incidence of cystic periventricular leukomalacia (cPVL) observed among preterm low birth weight infants and its risk factors. Methods : The medical records of infants (under 37 weeks of gestational age and under 2,500 g of birth weight) delivered from June 2003 to May 2006 were reviewed with special reference to cPVL. Maternal factors, labor and delivery characteristics and neonatal parameters were collected. It is inquired of whether the already known perinatal and neonatal risk factors such as prematurity, birth weight, intrauterine infection, mode of delivery, breech presentation, postnatal resuscitation and intubation, antenatal steroid, administration of surfactant and early onset of sepsis can be attributed to cPVL incidence of given infants. Results : Ventilator care was offered to 7 infants, and surfactant was applied to 6 infants among 10 infants who has cPVL. The incidence of cPVL is 7.2%. The risk factors like low Apgar score at 1 minute, twin, use of epinephrine or dopamine, postnatal administration of surfactant and ventilator care have statistical meaning (P<0.05). Conclusion : The incidence of cPVL is higher in the cases of low Apgar score at 1 minute, twin, delivery room resuscitation, respiratory distress syndrome and ventilator care. These risk factors should be controlled with special attention to their influences on the brain. By way of regular follow-up, careful observation of neurological problem must be given to infants required of epinephrine, dopamine and ventilator care. (J Korean Soc Neonatol 2007;14:22-29)