Risk factors of periventricular leukomalacia in singleton infants born from 23 rd to 26th weeks of gestation – Retrospective study

Introduction
Periventricular leukomalacia (PVL) is one of the most common hypoxic-ischemic pathologies among preterm newborns. The bracket most vulnerable to PVL are newborns born before 34 weeks’ gestation, especially those with very low and extremely low birth weights. In a population of very low birth weight newborns, the frequency of periventricular white matter injury (PWMI) including PVL is 5–15%. The aim of our study was to verify the potential risk factors of the occurrence of PVL among infants born between 23 and 26 weeks’ gestation.

Methods
The retrospective study included a group of 115 unrelated infants born between 23 and 26 week's gestation, hospitalized in the Neonatal Intensive Care in the Department of Neonatology, Poznan University of Medical Sciences in 2010–2014, born in the clinic or transported to it after birth in the hospital of lower references. The diagnosis of PVL was based on transcranial ultrasound.

Results
PVL was diagnosed in 17 (14.8%), including 5 (29.4%) infants born from 23 to 24 weeks’ gestation and 12 (70.6%) born from 25 to 26 weeks gestation. Higher incidence of PVL was found among infants born outside tertiary hospital (OR 7.933 (2.206–35.19); p = 0.0005) and newborns diagnosed with III and IV intraventricular hemorrhage (IVH) (OR 3.273 (1.042–10.28); p = 0.036).

Conclusions
Delivery in the third-level hospital as well as IVH prevention significantly reduces the risk of PVL. Well-developed prenatal care, fetus transport in utero and delivery in the third-level hospital seem to be crucial in the prevention of this pathology