Beltempo et al identified risk factors for severe neurologic injury in preterm neonates. These can help to guide cranial ultrasound to detect brain lesions. The authors are from the Canadian Neonatal Network and are from multiple institutions in Canada.
Patient selection: preterm infant < 33 weeks of gestation
Outcome: grade 3 or 4 intraventricular hemorrhage, periventricular leukomalacia (PVL)
Risk factors:
(1) singleton birth (adjusted odds ratio 1.96)
(2) 5-minute Apgar score < 7 (adjusted odds ratio 1.81)
(3) mechanical ventilation on day 1 (adjusted odds ratio 2.65)
(4) vasopressor therapy on day 1 (adjusted odds ratio 3.23)
Risk Factors
Risk Group
Severe Neurologic Injury
none
low
1.2%
1, singleton birth
moderate
1.8%
1, other than singleton
high
5.6%
>=2
high
5.6%
Ultrasound examination of the brain should be performed on infants:
(1) < 30 weeks of gestation
(2) 30 to 32 weeks of gestation and classified as moderate or high risk.
To read more or access our algorithms and calculators, please log in or register.
