Preterm infants with periventricular-intraventricular hemorrhage (PV-IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV-IVH. Previous studies on the pathogenesis of PV-IVH have focused mainly on comparisons of perinatal risk factors between patients with and without PV-IVH. Notably, most cases of PV-IVH occur within the first 3 days after birth, and the condition may worsen within 1 week following the initial diagnosis. However, the risk factors that contribute to the deterioration of PV-IVH have not been investigated. In this cohort study, 514 PV-IVH infants with a gestational age (GA) < 32 weeks were enrolled. The dependent variable was initially diagnosed as mild PV-IVH (grade I or II) that subsequently progressed to severe PV-IVH (grade III or IV) within 1 week. A stepwise forward multivariate logistic regression model was adopted to select potential or related factors that affected the deterioration of PV-IVH in preterm infants. Overall, 42 of the 514 infants with PV-IVH (8.2%) showed deterioration within 1 week. The results showed that maternal lower genital tract infection (OR 3.73, 95% CI 1.75-7.95) was an independent risk factor for PV-IVH deterioration. Higher GA (OR 0.62, 95% CI 0.48-0.80) was a protective factor. Our results suggest that maternal lower genital tract infection and a lower GA may contribute to PV-IVH deterioration in preterm infants. Periventricular-intraventricular hemorrhage (PV-IVH) is a common intracranial lesion in premature infants and is characterized as bleeding into the ventricular system due to the rupture of microvessels within the germinal matrix tissue 1. The incidence of PV-IVH is higher in neonates with a younger gestational age (GA) than in other groups and is especially high in neonates with GA < 32 weeks 2. PV-IVH ranges in severity from grade I to grade IV according to the Papile grading system 3. In the majority of infants with mild PV-IVH (grade I and II), the clinical prognosis is generally favorable 4. However, up to approximately 60% of infants with severe PV-IVH (grades III and IV) develop cerebral palsy and/or mental retardation 5. These severe sequelae create enormous social and financial burdens. To date, no treatment has been able to reduce the sequelae of IVH in preterm infants 6. Notably, PV-IVH mainly occurs within the first 3 days after birth and can progress rapidly early in life (within 1 week) 5,7. Therefore, it is very important to detect risk factors for PV-IVH deterioration as this could help pediatricians prevent deterioration from mild to severe PV-IVH. Previous studies have evaluated the risk factors for PV-IVH in preterm infants by comparing PV-IVH infants to those without PV-IVH, and these studies have identified vaginal delivery, intrauterine infection, asphyxia, postpartum mechanical ventilation, coagulopathy, thrombocytopenia, etc. as perinatal risk factors 8,9. Whether these risk factors contribute to PV-IVH deterioration remains unknown. Therefore, the present study was performed to explore t...

In VLBW Chinese infants, IVF, GA < 32 weeks, apnea, BPD, sepsis, PDA, and blood transfusion were independent perinatal risk factors for ROP.

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