690 - Risk Factors and Neurodevelopmental Outcomes of Persistent Periventricular Echogenicity in Preterm Infants

YOOJIN KIM, Chung-buk national university hospital, cheongju, Ch'ungch'ong-bukto, Republic of Korea; BORAM YI, Chungbuk National University Hospital, Cheongju-si, Ch'ungch'ong-bukto, Republic of Korea; Mihye Seok, Chungbuk national university hospital, Cheongju, Ch'ungch'ong-bukto, Republic of Korea

Background: Persistent periventricular echogenicity (PVE) is defined by the presence of echogenicity in the periventricular white matter and is associated with mild edema in the brains of premature infants. PVE is a common finding during the first two weeks of life in preterm infants, but when it continues beyond this period, it is classified as persistent PVE. The implications of persistent PVE for periventricular leukomalacia (PVL) and neurodevelopment remain unclear.

Objective: The aim of this study was to identify risk factors associated with persistent PVE in preterm infants and to evaluate its effect on neurodevelopmental outcomes.

Design/Methods: A retrospective analysis was conducted on the medical records of 220 neonates admitted between 2016 and 2022 in Chungbuk National University Hospital, including those born before 32 weeks of gestation or weighing less than 1500 grams. Cranial ultrasounds classified the infants into three groups: normal, PVE resolving within 2 weeks, and PVE persisting for more than 2 weeks. Neurodevelopment was assessed around a corrected age of 18 months using the Bayley Scales II-III.

Results: Among the 121 infants who met the inclusion criteria, 36 were classified as having normal findings on cranial ultrasound, 32 showed improvement of PVE within 2 weeks, and 53 had PVE that persisted for more than 2 weeks. There were no significant differences among the three groups in gestational age, birthweight, or sex. The group with persistent PVE exhibited a significantly higher prevalence of antenatal steroid use (p=0.020) and increased neonatal resuscitation in the delivery room (p=0.012). Additionally, infants with Respiratory Distress Syndrome (RDS) were more prevalent in this group (p < 0.001) and required longer durations of non-invasive ventilatory support (p=0.032). The results of the Bayley assessments conducted at a corrected age of 18 months revealed no significant differences in the Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) on the Bayley-II, or in cognitive, language, and motor scores on the Bayley-III among the three groups.

Conclusion(s): Although certain risk factors such as antenatal steroid use, neonatal resuscitation, and RDS were associated with persistent PVE, these factors did not result in significant differences in neurodevelopmental outcomes at 18 months of corrected age. Further research is needed to understand the long-term implications of persistent PVE on neurodevelopment.