A clinical scoring system to predict the development of intraventricular hemorrhage (IVH) in premature infants

Abstract

Low gestational age (GA), low Apgar score, and having bleeding diathesis were the most important risk factors for IVH. According to these risk factors, a scoring system was developed for IVH ranged from 0 to 5. According to the risk ratios (RR) obtained from the logistic regression model, low GA (≤ 28 gestational week), presence of bleeding diathesis within 7 days, and low Apgar score increased the risk of IVH (RR = 3.32 for GA ≤ 28 gestational week, RR = 6.7 for presence of bleeding diathesis in 7th day, RR = 3 for having low Apgar score). The score was validated successfully in 89 infants. The area under ROC curve was 0.85 for derivation cohort and 0.807 for validation cohort. The predictive ability of the IVH score for derivation and validation cohort was calculated. The negative predictive values of a score less than 4 were 96.4 and 59.1%. CONCLUSıON: Concerning IVH-related sequelae which continue to be a major public health problem, we have developed a feasible predictive model for evaluating the risk for developing IVH for preterm infants in the first 7 days of life.

Cerebral Oxygenation and Autoregulation in Very Preterm Infants Developing IVH During the Transitional Period: A Pilot Study

“…GMH-IVH infants had a significantly lower GA and Apgar score compared to controls. This is consistent with previous data investigating the predictive risk factors for GMH-IVH development (22,23). Although an inverse correlation between TOHRx and GA has been previously reported (12), in the present study the between-group difference was observed only before, and not after GMH-IVH development.…”

Neuroprotective effect of ACTH on collagenase-induced peri-intraventricular hemorrhage in newborn male rats

“…Neuroprotective interventions have been tested to reduce PIVH incidence and its severity 7 , 8 . The prophylactic use of antenatal corticosteroids (e.g., a complete course of betamethasone) reduced the incidence of PIVH in neonates 7 , 10 , 43 . However, repeated antenatal glucocorticoid courses can cause adverse effects on fetal growth and cerebral cortical maturation 7 without further reducing the incidence of PIVH 44 .…”

“…Peri-intraventricular hemorrhage (PIVH) is one of the most serious prematurity-related illnesses 5 , 6 because of its incidence (15–30% of infants born at less than 32 weeks’ gestational age) and the severity of brain injury 7 , 8 . The incidence of PIVH is inversely proportional to the gestational age and the newborn weight 3 , 9 , 10 , with a higher risk in male newborns 11 .…”

“…The pathogenesis of PIVH is multifactorial and related to vascular, intravascular, and extravascular factors 7 , 8 . They involve the fragile capillary wall of the subependymal GM in the subventricular zone of the brain 7 , deficient/immature extravascular support, disturbances in cerebral blood pressure and flow pattern 5 , 7 , 8 , 10 , and impaired coagulation in some cases 7 , 8 . As a consequence of PIVH, medullary venous flow obstruction, thrombi and infarction can lead to perivascular hemorrhage and periventricular hemorrhagic necrosis 7 , 8 .…”

“…Clinical presentation varies depending on the extension of PIVH and brain damage over time 8 . PIVH can lead to post-hemorrhagic hydrocephalus, periventricular leukomalacia, gray and white matter dysmaturation, cerebellar underdevelopment, cerebral palsy, seizures, and cognitive deficits 6 – 8 , 10 .…”