A population-based study of cystic white matter injury on ultrasound in very preterm infants born over two decades in Nova Scotia, Canada

To identify the temporal trends, risk factors and outcomes of cystic white matter injury (WMI) detected by ultrasound in a population-based cohort of very preterm infants (VPI) with a minimal risk of selection bias. All live-born VPIs between 22 and < 31 weeks gestational age born in Nova Scotia, Canada from 1993 to 2013. Cystic WMI was identified in 87 (7%) out of 1184 eligible infants. The gestational age and mortality adjusted prevalence of cystic WMI decreased over time (p = 0.04). In multivariable analysis, chorioamnionitis, antenatal steroids, admission hypothermia, ventilator support, inotropes, and non-Coagulase-negative Staphylococcal and fungal infections were independently associated with cystic WMI. Cerebral palsy was the most common disability in the survivors, however, half of the survivors had none or mild disability. This cohort study demonstrated a decreasing trend in the incidence of cystic WMI and reported population-based neurological outcomes with cystic WMI, which is important for health-care planning and parental counseling.