Cranial Sonography for Newborn Screening: A 10-year Retrospective Study in11,887 Newborns

Abstract

We retrospectively analyzed the results of a sonographic cranial screening, study, performed between 1985 and 1994 to determine the inci cir:lCe of intracranial hemorrhage and cerebral anomalies based on obstetrical risk factors. I n the Department of Obstetrics and Gynecology of the University Giessen. Giessen. Germany, 94.6% (n =: i.887) of all children born during the study period were 111 Cilicied and underwent sonographic cranial screening within the first 10 days after bi1th. Cerebral abnormalities were found in 653 (= 5.5 %) cases. and periintraventricular hemor­rhages ( PIVH, grade I-IV) in 303 cases. Periventricular leucomala­cia. porencephaly, subarachnoidal hemorrhage and hydrocephaly were rare (s 0.2 %).The Apga r index proved to be a good prognostic factor. particularly at 1 and 5 minutes after birth (p < 0.0001 ). In contrast. correlation between PIVH and cardiotocography, arterial cord blood gases, and pH was poor. We did not observe a h1gher incidence of PIVH in newborns with growth retardation. pree­clampsia and premature ruptures of membranes or prolonged la­bor. With decreasing gestational age, the frequency of PIVH in­ creased progressively from 0.4 % at 39 weeks to 53.2 % at 27 weeks (p < 0.001 ). We also found a higher risk of intracrania l he­ morrhage in preterm newborns with amniotic infections (38.1 %, p < 0.001). In mature babies.we did not find a difference between the incidence of PIV H and delivery-modes: however, we noted a higher risk of PIVH Grade IV in preterm newborns with breech presentation for vaginal delivery versus caesarean section (38.5 % versus 7.4 %, p = 0.005 ). The Incidence of PIVH over this 10 year time period did not increase despite an increasing number of pre­term newborns over time.In conclusion this study which represents one of the largest patient cohorts studied for PIVH , indicates that neonatal sonographic cranial screening is an important tool to define quality control in obstetrics.