Original ArticleWhite matter damage and intraventricular hemorrhage in very preterm infants: the EPIPAGE study☆
Section snippets
Methods
We included all the births for 1997 for which the GA of the infant was 22 to 32 weeks that occurred in the maternity wards of nine French regions accounting for about one third of all births in France.5 Quadruplets were excluded. Of the remaining 2774 liveborn infants, 2767 were admitted to a neonatal intensive care unit (NICU). Cranial US was performed with high-frequency 7.5-MHz transducers. At all the participating centers, cranial US was performed by qualified neonatologists or radiologists
Results
Among the 2767 infants admitted to the NICU, 2667 (96.4%) infants had one or more US scans, 67 (2.4%) had no US scan, and for the 33 (1.2%) remaining infants, no information was available concerning US scans. Of the infants with US scans, 11% had only one US scan (20% of these children died in the NICU), 23% had two scans (10% died in the NICU), and 66% had three or more scans (8% died in the NICU); 59% of the infants who died within 48 hours had at least one scan.
White matter damage was
Discussion
In our study, GA was highly predictive of WMD (defined as PHI, cystic PVL, isolated ventricular dilatation, or persisting echodensities) and, in particular, of major WMD (cystic PVL and PHI). IUGR was associated with a higher risk of PHI but did not affect the risk of cystic PVL. Half the infants with major WMD died in the NICU. Cystic PVL was associated with IVH with or without ventricular dilatation.
The power of this study is high, given the number (2667) of very preterm infants included on a
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Supported by INSERM (National Institute of Health and Medical Research), Merck-Sharp and Dohme-Chibret, the Medical Research Foundation, and the Directorate General for Health of the French Ministry for Social Affairs.