Multicenter investigation for incidence of periventricular leukomalacia in premature infants in China

Abstract:

OBJECTIVE: Sponsored by the Subspecialty Group of Neonatology of Pediatric Society, China Medical Association, more than 10 large-scale hospitals participated in the near two-year multicenter investigation for brain injuries in premature infants in China. This study presented the investigation result for the incidence of periventricular leukomalacia (PVL) in premature infants from 10 Third Class A Level hospitals. METHODS: The premature infants with a gestation age <37 weeks in the 10 hospitals were given routine cranial ultrasound scanning within seven days after birth, and then repeated every 3-7 days until discharge from January 2005 to August 2006. The severity of PVL was graded based on de Vries classification. RESULTS: A total of 4 933 premature infants were enrolled. The total incidence of PVL and the incidence of cystic PVL were 2.3% (112/4 933) and 0.3% (16/4 933), respectively. Of the 112 PVL cases, 96 (85.7%) were with grade I, 14 (12.5%) with grade II, and 2 (1.8%) with grade III. The incidence of PVL in 4 maternal and child health care hospitals were significantly lower than that in 6 general or children's hospitals (1.4% vs 2.8%) (χ2=10.284, P<0.01). Vaginal delivery and mechanical ventilation were possible high-risk factors for the development of cystic PVL. CONCLUSIONS: The data of the multicenter investigation can basically reflect the situation about the occurrence of PVL in premature infants in major big cities of China. It is important to improve the ability to recognize the sonogram of non-cystic periventricular white matter injury.