Lenticulostriate Vasculopathy in Very-Low-Birth-Weight Preterm Infants: A Longitudinal Cohort Study

Yi-Li Hung; Chung-Min Shen; Kun-Long Hung; Wu-Shiun Hsieh

doi:10.3390/children8121166

Lenticulostriate Vasculopathy in Very-Low-Birth-Weight Preterm Infants: A Longitudinal Cohort Study

Children (Basel). 2021 Dec 9;8(12):1166. doi: 10.3390/children8121166.

Authors

Yi-Li Hung^{1

2}, Chung-Min Shen^{1

2}, Kun-Long Hung^{2

3}, Wu-Shiun Hsieh^{1

4

5}

Affiliations

¹ Department of Pediatrics, Cathay General Hospital, Taipei 10630, Taiwan.
² School of medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan.
³ Department of Pediatrics, Fu-Jen Catholic University Hospital, New Taipei City 243, Taiwan.
⁴ Department of Pediatrics, National Taiwan University Children's Hospital, Taipei 100, Taiwan.
⁵ Department of Pediatrics, National Taiwan University College of Medicine, Taipei 100, Taiwan.

Abstract

Background: The pathogenesis and clinical significance of lenticulostriate vasculopathy (LSV) are unclear. Our study aimed to determine the prevalence, presentation, and evolution of LSV, and the perinatal risk factors associated with LSV among very-low-birth-weight (VLBW) preterm infants.

Methods: One-hundred-and-thirty VLBW preterm infants were retrospectively enrolled in this study. Serial cranial ultrasound examinations were performed regularly from birth until a corrected age of 1 year. Infants with LSV were assigned to early-onset (≤10 postnatal days) and late-onset (>10 postnatal days) groups. Data describing the infants' perinatal characteristics, placental histopathology, and neonatal morbidities were collected, and the groups were compared.

Results: Of the VLBW infants, 39.2% had LSV before they were 1 year old. Linear-type LSV was the most common presentation, and >50% of the infants had bilateral involvement. LSV was first detected at 112 ± 83 postnatal days, and its detection timing correlated negatively with gestational age (GA) (R² = 0.153, p = 0.005) and persisted for 6 months on average. The infants with and without LSV had similar perinatal characteristics, placental pathologies, cytomegalovirus infection rates, and clinical morbidities. The late-onset LSV group comprised 45 (88.2%) infants who had a significantly higher rate of being small for gestational age (SGA) and used oxygen for longer than the infants without LSV. After adjusting a multivariable regression model for GA and SGA, analysis showed that the duration of oxygen usage was an independent risk factor for late-onset LSV development in VLBW infants (odds ratio: 1.030, p = 0.032).

Conclusion: LSV may be a nonspecific marker of perinatal insult to the developing brains of preterm infants. Prolonged postnatal oxygen usage may predispose VLBW preterm infants to late-onset LSV development. The long-term clinical impacts of LSV should be clarified.

Keywords: cranial ultrasound; lenticulostriate vasculopathy; prematurity; very-low-birth-weight.