Natarajan G, et al. - Researchers performed this study to describe the frequency and findings of cranial imaging in moderately preterm infants (born at 290/7-336/7 weeks of gestation) across centers. The association between abnormal imaging and clinical characteristics was also investigated. Among the 60% of moderately preterm infants with cranial imaging, intracranial hemorrhage, cystic periventricular leukomalacia or late ventriculomegaly were observed in 15%.

Methods

• Data was used from the Neonatal Research Network Moderately Preterm Registry, including the most severe early (≤28 days) and late (>28 days) cranial imaging.
• Researchers performed stepwise logistic regression and CART analysis after adjustment for gestational age, antenatal steroid use, and center.

Results

• A total of 4,184 (60%) infants underwent cranial imaging among 7,021 infants.
• Compared with those without imaging (P < .0001), these infants had lower gestational ages and birth weights and higher rates of small for gestational age, outborn birth, cesarean delivery, neonatal resuscitation, and treatment with surfactant.
• The researchers noted imaging abnormalities in 15% of the infants included any intracranial hemorrhage (13.2%), grades 3-4 intracranial hemorrhage (1.7%), cystic periventricular leukomalacia (2.6%), and ventriculomegaly (6.6%).
• Factors associated with abnormal imaging were histologic chorioamnionitis (OR, 1.47; 95% CI, 1.19-1.83), gestational age (0.95; 95% CI, 0.94-0.97), antenatal steroids (OR, 0.55; 95% CI, 0.41-0.74), and cesarean delivery (OR, 0.66; 95% CI, 0.53-0.81).
• The center with the highest rate of cranial imaging had a higher risk of abnormal imaging compared with the lowest (OR, 2.08; 95% CI, 1.10-3.92).
• The classification and regression-tree model revealed that cesarean delivery, center, antenatal steroids, and chorioamnionitis, in that order, predicted abnormal imaging.