Abstract
Aim/ subject: Magnetic resonance imaging (MRI) has contributed to the understanding of brain damage in infants with extremely low gestational age (ELGA, <27w). Data from Scandinavia, which has a long tradition of minimal intervention in the treatment of preterm infants, have not been reported yet. In this abstract we present the first results of an ongoing population based MRI study performed in the Stockholm area of Sweden.
Methods: All ELGA infants born in the Stockholm area in 2004 (n=51; birth weight: mean 770g, range 465 - 1114g; gestational age: mean 25+2w, range 23+2 - 26+6w) were included. Perinatal data and clinical courses were prospectively collected. At term equivalent age infants were scanned with conventional MRI using a 1.5 Tesla magnetic resonance system (Philips Intera). Images were reviewed by 3 independent observers using a scoring system for grey and white matter abnormalities (Inder et al 2003).
Results: 33 infants (birth weight: mean 805g (range 554 - 1114g); mean GA 25+4w (range 23+5 - 26+6w) were included in the analysis. Out of 51, 10 had died before term age, in 2 no parental consent was obtained, one was excluded because of chromosomal disorder, 2 because of connatal CMV infection, 1 moved outside Sweden, 2 have not reached term age yet. Normal white matter (WM) was found in 21%, mild WM abnormalities in 58%, moderate to severe non-cystic WM abnormalities in 21%, cystic WM abnormalities in none. GM scores were normal in 90% and abnormal in 10%.
Conclusion: Cystic WM damage was not seen in any infant. Non-cystic white matter abnormalities were found in 79% and abnormal grey matter in 10% of our ELGA infant population. To evaluate the clinical relevance of these findings neurological follow-up of these children is ongoing.
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Horsch, S., Hallberg, B., Nagy, Z. et al. 176 Non-Cystic White Matter Damage in ELGA Infants – A Swedish Population Based Study. Pediatr Res 58, 384 (2005). https://doi.org/10.1203/00006450-200508000-00205
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DOI: https://doi.org/10.1203/00006450-200508000-00205
