Incidence and Timing of Germinal Matrix/Intraventricular Hemorrhage in Low Birth Weight Infants

Abstract

Incidence and time of onset of germinal matrix/intraventricular hemorrhage (GM/IVH) were prospectively ascertained in 1,105 infants weighing < or = 2,000 g at birth, a cohort comprising about 85% of all births of that weight born from September 1984 to June 1987 in the central New Jersey counties of Ocean, Monmouth, and Middlesex. Cranial ultrasonography was performed as nearly as possible to age 4 hours, 24 hours, and 7 days. Each scan was reviewed by two independent readers and, if necessary, a third; consensus was achieved on scan of first diagnosis of GM/IVH in 965 of the 1,079 infants with assessable scans. The cumulative incidence of GM/IVH in the first week of life was 24.6% (265/1,079). In the 965 infants with consensus diagnoses, the first scan, at 4.9 +/- 2.2 hours, yielded the highest incidence--10.6% (95/899). Incidence by the second scan (25.1 +/- 4.9 hours) was 6.0% (49/813), and by the third scan (7.2 +/- 0.8 days), 9.0% (64/715). The iterative algorithm for interval-censored data developed by Turnbull (J R Stat Soc [B] 1976;8:290-5) was used to estimate the most likely time of onset based on time of first diagnosis. From 34% to 44% of hemorrhages were present at the first opportunity to scan, which in these data was at age 1 hour. At least a third of GM/IVH in infants < or = 2,000 g appears to be of congenital or immediate postnatal onset.

Effects of Antenatal Corticosteroids on Blood Pressure in Very Low Birth Weight Infants During the First 24 Hours of Life

“…41 Of all the infants who developed IVH, 40% did so within the first 5 hours of life. 42 In addition, hypotension has an independent adverse effect on neonatal outcome at 24 months of age. 43 This study was not designed to assess the effect of antenatal corticosteroids on neonatal IVH, and we did not find a statistically significant difference in the rates of IVH.…”

Routine screening cranial ultrasound examinations for the prediction of long term neurodevelopmental outcomes in preterm infants

“…Among infants who developed GM and/or IVH, at least one-third of the infants had echodensities as early as 1 h after birth, indicating an antenatal or immediate postnatal onset (25,26). Approximately 50% of GM and/or IVH occurred in the first 6 to 8 h after birth (27).…”

Intracisternal Application of Endotoxin Enhances the Susceptibility to Subsequent Hypoxic-Ischemic Brain Damage in Neonatal Rats

“…those born before 32 wk of gestation (3). In addition, the incidence of peri/intraventricular hemorrhage is significantly increased in premature infants who are exposed to intrauterine inflammation (5,6). …”