OP14.10: White matter damage and hemorrhagic brain lesions in severely preterm infants with and without intrauterine growth restriction

To compare the prevalence of cerebral transient periventricular echodensities (TPE), periventricular leukomalacia (PVL) and hemorrhagic brain lesions (HBL) in severely preterm neonates with and without intrauterine growth restriction (IUGR). Fifty-nine IUGR, and 57 adequate for gestational age (AGA) singleton infants born between 24 and 34 weeks' gestational age were studied. The presence of TPE, PVL, and HBL was assessed with neonatal cranial ultrasound (US) at day 3 (US-I), 2 weeks after delivery (US-II), and at term-equivalent age (US-III). Mean gestational age at delivery and birth weight were: 30 + 1 weeks (27 + 3 to 33 + 3), 1030 g (370–2110) for IUGR neonates, and 29 + 2 (26 + 2 to 34 + 1), 1277 g (710–2250) for non-IUGR infants. IUGR neonates had an increased prevalence of TPE at US-I (22/59 vs. 10/57; P = 0.02) and an increased prevalence of PVL at US-II (10/55 vs. 3/56; P = 0.04) and US-III (10/48 vs. 3/53; P = 0.03) than AGA preterm infants. The prevalence of HBL was significantly higher in AGA preterm neonates at US-I (3/59 vs. 12/57; P = 0.01) and in IUGR neonates at US-II (8/55 vs. 2/56; P = 0.04) and US-III (8/48 vs. 3/53; P = 0.1). Intrauterine-growth-restricted preterm neonates have a significant increment in the prevalence of hypoxic–ischemic and hemorrhagic brain lesions than appropriate-for-gestational age preterm neonates.