Impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in very preterm infants at two years of age

Périsset, Alexandra; Natalucci, Giancarlo; Adams, Mark; Karen, Tanja; Bassler, Dirk; Hagmann, Cornelia

doi:10.1016/j.earlhumdev.2023.105721

Cited by 9 publications

(5 citation statements)

References 50 publications

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“…shown by a few reports that grade 1 and 2 IVH was associated with higher rates of cerebral palsy, visual impairments, and NDI at 2 years of CA 18) , with other reports showing that lowgrade IVH does not affect cognitive, motor, and academic outcomes at school age 19) . Patra et al 8) showed that the risk of adverse neuro developmental outcomes at 20 months CA was higher in ex tremely lowbirthweight infants with lowgrade IVH than in the control group.…”

Section: Discussionmentioning

confidence: 93%

Neurodevelopmental Outcomes and Brain Volumetric Analysis of Low-Grade Intraventricular Hemorrhage

et al. 2023

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Purpose: Extremely preterm infants are prone to brain injury and underdevelopment. Intraventricular hemorrhage (IVH) is the most common cause of brain injury and a significant risk factor for neurodevelopmental delay in preterm infants. Severe IVH is known to have a poor outcome; however, the outcomes of low-grade IVH remain controversial. This study aimed to evaluate neurodevelopmental outcomes and brain segmental volumes of preterm infants with low-grade IVH.Methods: This retrospective cohort study included 109 extremely preterm infants who underwent term equivalent age-magnetic resonance imaging and neurodevelopmental evaluation at a corrected age of 18 to 24 months. We compared infants with and without low-grade IVH.Results: Among the 109 extremely preterm infants, 25 had low-grade IVH and 84 had no IVH. There were no significant differences in the neurodevelopmental outcomes between the low-grade and no IVH groups. In multivariate analysis, low-grade IVH was associated with a smaller medullary volume (adjusted odds ratio, 0.575; 95% confidence interval, 0.346 to 0.957; <i>P</i>=0.034).Conclusion: We found no significant differences in the neurodevelopmental outcomes of extremely preterm infants at a corrected age of 18 to 24 months between those with low-grade IVH and those without IVH. Low-grade IVH was associated with a smaller medullary volume.

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Section: Discussionmentioning

confidence: 93%

Neurodevelopmental Outcomes and Brain Volumetric Analysis of Low-Grade Intraventricular Hemorrhage

et al. 2023

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“…The main outcome was ≥ grade II IVH (grade II, grade III and/or periventricular infarct) or early death (ED) 20,21 . We chose this outcome because there is evidence that grade II IVH is associated with a signi cantly worse prognosis than grade I IVH.…”

Section: Discussionmentioning

confidence: 99%

“…We chose this outcome because there is evidence that grade II IVH is associated with a signi cantly worse prognosis than grade I IVH. 20 ED was de ned as death in the rst 7 days of life and was included in the composite outcome given that more than 90% of IVH cases occur within the rst week of life. 22 The secondary outcomes were any grade IVH, grade III IVH-periventricular infarct, Grade III IVH-periventricular infarct and/or ED and posthemorrhagic ventricular dilatation requiring shunt placement.…”

Section: Discussionmentioning

confidence: 99%

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

Terroba-Seara,

Oulego-Erroz,

Palanca-Arias

et al. 2024

J Perinatol

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ObjectiveTo determine whether early screening for low systemic blood ow is associated with reduced intraventricular hemorrhage in preterm infants. Study designProspective, observational multicenter study in nine neonatal intensive care units. Preterm infants younger than 33 weeks of gestational age were eligible. The exposure was protocolized early echocardiography screening for low systemic blood ow. Our main outcome was ≥ grade II intraventricular hemorrhage or death within the rst 7 days of life. The main analysis used the inverse probability of treatment weighting based on propensity scores. Results332 preterm infants (131 in the intervention group and 201 in the control group) were included. Early echocardiography screening was associated with a signi cant reduction in ≥ grade II intraventricular hemorrhage or early death [odds ratio 0.285 (95% CI: 0.133-0.611); p = 0.001]. ConclusionsEarly echocardiography screening for low systemic blood ow may reduce the incidence of intraventricular hemorrhage in preterm infants.

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“…The main outcome was > grade II IVH (grade II, grade III and/or periventricular infarct or early death (ED) [21,22]. We chose this outcome as there is evidence that grade II IVH carries signi cant worse prognosis compared to grade I IVH.…”

Section: Discussionmentioning

confidence: 99%

“…We chose this outcome as there is evidence that grade II IVH carries signi cant worse prognosis compared to grade I IVH. [21] ED was de ned as death in the rst 7 days of life and was included in the composite outcome given that more than 90% of IVH cases occur within the rst week of life. [23] Secondary outcomes were any grade IVH, grade III IVH-periventricular infarct, grade III IVHperiventricular infarct and/or ED and posthemorrhagic ventricular dilatation needing shunt placement.…”

Section: Discussionmentioning

confidence: 99%

Association Between Early Echocardiography Screening and Intraventricular Hemorrhage in Preterm Infants: A Prospective Observational Multicenter Study

Terroba-Seara,

Oulego-Erroz,

Palanca-Arias

et al. 2023

Preprint

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Purpose:To determine whether the application of a protocolized early echocardiographic screening for low systemic blood flow and guided inotropic therapy is associated with reduced intraventricular hemorrhage in preterm infants. Methods: Prospective, observational multicenter study between September 2020 and September 2021 in nine neonatal intensive care units. Preterm infants below 33 weeks of gestational age were eligible. The exposure variable was early targeted neonatal echocardiography screening for low systemic blood flow. Five of the centers performed early screening and guided inotrope therapy (intervention group), and 4 centers did not (control group). Our main outcome was >grade II intraventricular hemorrhage or death within the first 7 days of life. Inverse probability of treatment weighting based on the propensity score accounting for the clustered nature of data was used for the main analysis. Results: 332 preterm infants (131 in the intervention group and 201 in thecontrol group) were included. Protocolized early echocardiography screening for low systemic blood flow and guided inotropic treatment was associated with a significant reduction in > grade II intraventricular hemorrhage or early death (odds ratio 0.285 (95% CI: 0.133-0.611); p=0.001) Conclusions: Early echocardiography screening for low systemic blood flow and guided inotropic treatment may reduce the incidence of intraventricular hemorrhage in preterm infants.

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Impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in very preterm infants at two years of age

Cited by 9 publications

References 50 publications

Neurodevelopmental Outcomes and Brain Volumetric Analysis of Low-Grade Intraventricular Hemorrhage

Neurodevelopmental Outcomes and Brain Volumetric Analysis of Low-Grade Intraventricular Hemorrhage

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

Association Between Early Echocardiography Screening and Intraventricular Hemorrhage in Preterm Infants: A Prospective Observational Multicenter Study

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