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Goeral K, Schwarz H, Hammerl M, Brugger J, Wagner M, Klebermass-Schrehof K, Kasprian G, Kiechl-Kohlendorfer U, Berger A, Olischar M. Longitudinal Reference Values for Cerebral Ventricular Size in Preterms Born 23-27 Weeks. J Pediatr. 2021 Jun 29:S0022-3476(21)00647-8.

Objectives: To establish longitudinal reference values for cerebral ventricular size in the most vulnerable patients at risk for intraventricular hemorrhage and posthemorrhagic ventricular dilatation (PHVD).

Study design: This retrospective study included neurologically healthy preterm neonates born at 23+0 to 26+6 weeks gestational age (GA) between September 2011 and April 2019. Patients were treated at two Austrian tertiary centers (Medical University of Vienna and Medical University of Innsbruck). All available cerebral ultrasound scans until 30 weeks corrected age were analyzed. Ventricular measurements included Ventricular Index (VI), Anterior Horn Width (AHW), and Thalamo-occipital Distance (TOD) and longitudinal percentiles were created.

Results: The study cohort consisted of 244 preterm neonates. Median GA was 25+3 (24+4-26+0), median birth weight 735 grams (644-849). A total of 993 ultrasound scans were available for analysis resulting in >1800 measurements of VI, AHW and TOD. Special attention was given to the 97th percentile as well as 2mm and 4mm above the 97th percentile, internationally used as cutoffs for intervention in the presence of PHVD.

Conclusions: We present percentile charts based on a cohort of extremely premature infants including neonates born at the border of viability suited to follow-up the most vulnerable patients at risk for intraventricular hemorrhage and PHVD. Furthermore, we provide an extensive literature research and comparison of all available reference values focusing on VI, AHW and TOD.

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