Correlation Analysis of MRI Quantitative Assessment of White Matter Damage with Blood Cell Parameters and Perinatal Factors in Premature Infants
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0413
- VernacularTitle:早产儿脑白质损伤核磁共振成像定量评估与血细胞参数和围产期因素的相关性分析
- Author:
Jun-yan ZHONG
1
;
Xue-yu CHEN
2
;
Mo YANG
1
Author Information
1. Department of Pediatrics， Affiliated Nanfang Hospital， Southern Medical University， Guangzhou 510515， China
2. Department of Neonatology， Affiliated Shenzhen Maternity Child Healthcare Hospital， Southern Medical University， Shenzhen 518028， China
- Publication Type:Journal Article
- Keywords:
preterm infants;
white matter damage;
high risk factors;
blood cell parameters
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(4):571-580
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the correlation between perinatal risk factors and blood cell parameters of white matter damage （WMD） in premature infants and to provide scientific basis for early detection and avoidance of WMD in premature infants. MethodsThis is a retrospective study performed at the Neonatal Department， Affiliated Shenzhen Maternity ＆ Child Healthcare Hospital， from January 1st 2018 to December 31st 2020. The case group included 85 premature infants diagnosed as WMD by MRI， and 115 premature infants without WMD matched by gestational age and admission date constituted the control group. SPSS 22.0 statistical software was used to conduct univariate analysis of perinatal related factors and blood cell parameters， and to construct a multivariate Logistic regression model to analyze WMD related factors. Meaningful continuous variables were analyzed by the receiver operating characteristic curve to obtain the cut-off value of WMD risk factors. Then ordinal Logistic regression was used to analyze the influencing factors of WMD severity. Results① There were no significant differences in sex ratio，twins rate，gestational age，birth weight，cesarean section rate，assisted reproductive technology pregnancy rate，Apgar score at 1 and 5 minutes after birth， and age at diagnosis between the two groups （P>0.05）. ② Univariate analysis of perinatal factors showed that there were significant differences between the two groups in the rate of anemia during pregnancy，antenatal glucocorticoid treatment，the incidence of early-onset sepsis，neonatal hypotension，PIVH （grade Ⅲ-Ⅳ） and hsPDA， the proportion of mechanical ventilation （≥7 d）（P<0.05）. ③ Univariate analysis of blood cell parameters in the first week after birth showed that there were significant differences in WBC，Neut，Mono，MCV，MCH，PLT，PCT，MPV and PDW between the two groups（P<0.05）. ④ Logistic regression model showed that mechanical ventilation （≥7 d） was an independent risk factor for WMD，while higher MCH and PLT within one week after birth and antenatal glucocorticoid treatment were protective factors for WMD. ⑤ The AUC of MCH in the diagnosis of WMD was 0.708，95% CI was （0.595-0.820）， and the cut-off value was 37.10 pg. The AUC of WMD diagnosed by PLT was 0.669， 95% CI was （0.551-0.787） and the cut-off value was 227.50×109/L. ⑥ Ordered Logistic regression showed that early-onset sepsis was a risk factor for the severity of WMD， while gestational age and platelet distribution width were its protective factors and hematology indicators. ConclusionsMechanical ventilation （≥7 d） decreased MCH and PLT counts may be independent risk factors for WMD in preterm infants， and antenatal glucocorticoids treatment is a protective factor.Early-onset sepsis， smaller gestational age and PDW may be risk factors for the severity of WMD.
