NEW ORLEANS -- Culture-positive neonatal infection is associated with development of white matter injury, which is a major precursor of neurologic impairment and cerebral palsy, Dr. Cynthia Holcroft said at the annual meeting of the Society for Maternal-Fetal Medicine.
Positive neonatal urine, blood, cerebrospinal fluid, and tracheal cultures each occurred more often among 150 babies with white matter injury than among 150 controls in a retrospective study of births between 23 and 34 weeks' gestation.
White matter injury in this study was characterized by periventricular leukomalacia or ventricular dilatation; the babies studied were free of other chromosomal abnormalities and congenital anomalies, said Dr. Holcroft of Johns Hopkins University, Baltimore. Compared with controls, the babies with white matter injuries had higher percentages of positive urine cultures (13% vs. 7%), blood cultures (29% vs. 19%). CSF cultures (17% vs. 6%), and tracheal cultures (22% vs. 9%). The differences were significant for the blood, cerebrospinal, and tracheal cultures.
There was also an association between multiple gestation and white matter injury; 24% of cases were from a multiple gestation, compared with 14% of controls.
Histologic funisitis and chorioamnionitis were not associated with an increased risk of neonatal white matter injury, and there were no significant differences between cases and controls with regard to intrauterine growth restriction, cesarean delivery, preeclampsia, steroid use, preterm premature rupture of membranes, abruption, placenta previa, or incidence of metabolic acidosis, Dr. Holcroft noted.
BY SHARON WORCESTER
COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group