Neurodevelopmental outcomes of infants with periventricular leukomalacia at 2 years of age according to the De Vries classification

Abstract

Background: Periventricular leukomalacia is a white matter lesion, characterized by focal necrotic
cysts, diffuse gliosis, ventriculomegaly, axonal damage. It is the most frequent cause of cerebral palsy
and sensory deficits in premature infants.
Material and methods: Observational, retrospective, and analytical study of a cohort of newborns who
presented periventricular leukomalacia at birth, according to the 4 stages of the De Vries classification.
Patients were assessed at 2 years of age by Amiel Tison and Mayo Clinic neurological examinations,
neurobehavioral assessment, Bayley Scale of Infant Development, Human Communication and
Anthropometry services.
Results: 110 infants diagnosed by ultrasound were examined at two years of age. No correlation was
found between the De Vries classification and the assessments. Average gestational age was 30.2
weeks, average weight 1197g. 35.5% were healthy mothers, followed by 28.2% with preeclampsia.
The most frequent pathologies were neonatal sepsis and intraventricular hemorrhage, but they were
not statistically significant. Amiel Tison neurological assessment was abnormal in 87.3% at one year
of age, at two years of age cerebral palsy was present in 63.7%, the neurobehavioral assessment
showed 15.5% of severe problems, there was severe hearing loss in 2.7%, and language at 2 years
corresponded to the 15.8 month level. Bayley MDI was significantly delayed in 31.8% as well as PDI.
Conclusion: This work showed no correlation of the different variables with the De Vries Classification.
In general terms, neurodevelopment assessments demonstrated an evident neurodevelopmental
impairment with 63.7% of cerebral palsy and a significant delay of 31.8% for MDI and PDI.