Analysis Of Risk Factors Associated With Brain MRI In The Diagnosis Of Premature Infants

Objective: To analyze the risk factors associated with brain injury in premature infants diagnosed by MRI,and to provide theoretical basis for intervention in preventing neonatal brain injury in this area.Method:(1)176 cases of premature infants from the neonatal intensive care unit of our hospital were selected from June 1st,2016 to June 30 th,2017.After the hospital,MRI was performed on the head.The results of brain MRI diagnosis of premature infants with brain injury were analyzed.Related risk factors: gender,gestational age,birth weight,mode of delivery,history of asphyxia,single/twin,conception,premature rupture of membranes,pregnancy-related illness,pre-natal use of magnesium sulfate,prenatal Use hormones,mechanical ventilation,endocrine and metabolic diseases.(2)The brain injury cases of premature infants were divided into non-hemorrhagic brain injury group and hemorrhagic brain injury group.(3)Univariate analysis of risk factors for brain injury in each group,followed by statistical analysis of the main risk factors of brain damage in preterm infants with single factor,and the risk factors and protective factors of the two groups were counted separately.Result:(1)Among 176 premature infants,there were 62 cases of brain injury and 114 cases of no brain injury.The incidence of brain injury in premature infants was 35.2%(62/176),and 30 cases were non-hemorrhagic brain injury,accounting for 48.3%.(30/62),including 19 cases of white matter damage,11 cases of hypoxic-ischemic brain damage;about37 cases of hemorrhagic brain injury,accounting for 59.6%(37/62),mainly 13 cases of periventricular-intraventricular hemorrhage There were 9 cases of subarachnoid hemorrhage,5 cases of periventricular-intraventricular hemorrhage with subarachnoid hemorrhage,and 6cases of non-hemorrhagic brain injury with hemorrhagic brain injury,accounting for 9.6%(6/62).(2)Among the six high-risk factors common in brain damage in premature infants: the difference in gender and mode of delivery is statistically significant.(3)Hemorrhagic brain injury in preterm infants: single factor analysis: delivery mode(P=0.07),birth weight(P=0.033)was statistically significant,multivariate logistic regression showed: delivery mode(P=0.07 OR=0.303),Birth weight(P=0.033 OR=1.859)had an independent effect on hemorrhagic brain damage.Caesarean section and low birth weight are protective factors,and delivery and high birth weight are risk factors.(4)Non-hemorrhagic brain injury group:Univariate analysis: gender(P = 0.4),premature rupture of membranes(P = 0.038),apnea(P= 0.035),mechanical ventilation(P = 0.023),sepsis(P = 0.03)Hypocalcemia(P=0.035)was statistically significant(P<0.05).Multivariate logistic regression showed that gender(P=0.4 OR=0.348)was an independent effect of non-hemorrhagic brain injury.Neonatal gender was lower in women with non-hemorrhagic brain damage than in men,premature rupture of membranes(P=0.016 OR=2.94),sepsis(P=0.011 OR=6.042),hypocalcemia(P=0.083 OR=6.028))as a risk factor.Conclusion:(1)The incidence of brain injury in premature infants in this region is about 35.2%.PVH-IVH is the main cause of hemorrhagic brain injury,and CWMD is the main non-hemorrhagic brain injury.(2)Cesarean section can reduce the incidence of hemorrhagic brain injury,and the birth weight of premature infants is directly proportional to the incidence of hemorrhagic brain injury.(3)The risk of non-hemorrhagic brain injury in male premature infants is higher than that in women.Septicemia,premature rupture of membranes,and hypocalcemia are risk factors for non-hemorrhagic brain injury.(4)Brain damage in premature infants is associated with a variety of factors,and these factors should be avoided and actively prevented during the perinatal period to reduce the incidence of non-hemorrhagic brain injury.