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Effect of chorioamnionitis on brain development and injury in premature newborns Chau, Vann; Poskitt, Kenneth J.; McFadden, Deborah E.; Bowen-Roberts, Tim; Synnes, Anne; Brant, Rollin; Sargent, Michael A.; Soulikias, Wendy; Miller, Steven P.
Abstract
Objective [ ] The association of chorioamnionitis and non-cystic white matter injury, a common brain injury in premature newborns, remains controversial. Our objectives were to determine the association of chorioamnionitis and postnatal risk factors with white matter injury, and the effects of chorioamnionitis on early brain development, using advanced MR imaging. Methods [ ] Ninety-two preterm newborns (24-32 weeks gestation) were studied at a median age of 31.9 weeks and again at 40.3 weeks gestation. Histopathological chorioamnionitis and white matter injury were scored using validated systems. Measures of brain metabolism (N-acetylaspartate/choline and lactate/choline) on magnetic resonance spectroscopy, and microstructure (average diffusivity and fractional anisotropy) on diffusion tensor imaging were calculated from predefined brain regions. Results [ ] Thirty-one newborns (34%) were exposed to histopathological chorioamnionitis, and 26 (28%) had white matter injury. Histopathological chorioamnionitis was not associated with an increased risk of white matter injury (relative risk: 1.2; P=0.6). Newborns with postnatal infections and hypotension requiring therapy were at higher risk of white matter injury (P<0.03). Adjusting for age at scan and regions of interest, histopathological chorioamnionitis did not significantly affect brain metabolic and microstructural development (P>0.1). In contrast, white matter injury was associated with lower N-acetylaspartate/choline (–8.9%; P=0.009) and lower white matter fractional anisotropy (–11.9%; P=0.01). Interpretation [ ] Histopathological chorioamnionitis does not appear to be associated with an increased risk of white matter injury on magnetic resonance imaging or with abnormalities of brain development. In contrast, postnatal infections and hypotension are associated with an increased risk of white matter injury in the premature newborn. Final published version [ ] Ann Neurol. 2009 Aug;66(2):155-64. URL: http://www3.interscience.wiley.com/journal/76507645/home
Item Metadata
Title |
Effect of chorioamnionitis on brain development and injury in premature newborns
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Creator | |
Publisher |
Wiley-Blackwell
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Date Issued |
2009
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Description |
Objective [ ]
The association of chorioamnionitis and non-cystic white matter injury, a common brain injury in premature newborns, remains controversial. Our objectives were to determine the association of chorioamnionitis and postnatal risk factors with white matter injury, and the effects of chorioamnionitis on early brain development, using
advanced MR imaging.
Methods [ ]
Ninety-two preterm newborns (24-32 weeks gestation) were studied at a median age of 31.9 weeks and again at 40.3 weeks gestation. Histopathological chorioamnionitis
and white matter injury were scored using validated systems. Measures of brain
metabolism (N-acetylaspartate/choline and lactate/choline) on magnetic resonance
spectroscopy, and microstructure (average diffusivity and fractional anisotropy) on
diffusion tensor imaging were calculated from predefined brain regions.
Results [ ]
Thirty-one newborns (34%) were exposed to histopathological chorioamnionitis,
and 26 (28%) had white matter injury. Histopathological chorioamnionitis was not
associated with an increased risk of white matter injury (relative risk: 1.2; P=0.6).
Newborns with postnatal infections and hypotension requiring therapy were at higher risk
of white matter injury (P<0.03). Adjusting for age at scan and regions of interest,
histopathological chorioamnionitis did not significantly affect brain metabolic and
microstructural development (P>0.1). In contrast, white matter injury was associated with lower N-acetylaspartate/choline (–8.9%; P=0.009) and lower white matter fractional
anisotropy (–11.9%; P=0.01).
Interpretation [ ]
Histopathological chorioamnionitis does not appear to be associated with an
increased risk of white matter injury on magnetic resonance imaging or with
abnormalities of brain development. In contrast, postnatal infections and hypotension are
associated with an increased risk of white matter injury in the premature newborn. Final published version [ ] Ann Neurol. 2009 Aug;66(2):155-64. URL: http://www3.interscience.wiley.com/journal/76507645/home
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Subject | |
Genre | |
Type | |
Language |
eng
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Date Available |
2010-03-18
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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DOI |
10.14288/1.0048541
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URI | |
Affiliation | |
Citation |
Annals of Neurology, 2009 Aug;66(2):155-64.
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Peer Review Status |
Unreviewed
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Scholarly Level |
Researcher; Faculty
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Copyright Holder |
Annals of Neurology (Wiley-Blackwell)
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Rights URI | |
Aggregated Source Repository |
DSpace
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Item Citations and Data
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International