Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study

Abstract

Objective: To assess the incidence of periventricular/intraventricular hemorrhage (PIVH) in very low birth rate neonates. Methods:This was a prospective cohort study conducted on a sample of very low birth weight infants over a 15-year period. Neonates who did not undergo cerebral ultrasonography, had malformations affecting the central nervous system, or died within the first 24 hours of life were excluded. Ultrasonography was performed through the anterior fontanelle using an Aloka ® 620 scanner with a 5 mHz probe, between days 1 and 3 of life, at 7 days, and at 28 days (or at discharge). Incidence was analyzed by means of the chi-square test for trend or Cochran-Armitage test and through a simple linear regression model with a logarithmic trendline as the output. For assessment of potential associated factors, a variety of obstetric, perinatal, and neonatal data collected between 1991-1994 and 2002-2005 were analyzed, using the chi-square and Fisher's exact tests for statistical analysis. The significance level was set at 5%.Results: Of 1,777 very low birth weight infants born during the study period, 1,381 (77.7%) were examined. Of these, 289 (20.9%) had PIVH. The yearly distribution of cases showed a progressive decline in incidence, from 50.9% in 1991 to 11.9% in 2005 (p < 0.0001). The incidence of PIVH decreased across all weight ranges as well as at grades I/II and III/IV. Significant differences in antenatal corticosteroid use, gender (male), weight (< 1,000 g), hyaline membrane disease, mechanical ventilation, administration of surfactant, patent ductus arteriosus, and sepsis were found. Conclusion:The incidence of PIVH in very low birth weight infants declined significantly during the study period. J Pediatr (Rio J). 2011;87(6):505-11:Cerebral hemorrhage, premature birth, ultrasonography. ResumoObjetivo: Avaliar a incidência da hemorragia peri-intraventricular (HPIV) em recém-nascidos de muito baixo peso.Métodos: Foi realizado estudo de coorte prospectiva de recém-nascidos de muito baixo peso ao longo de 15 anos. Excluíram-se aqueles sem avaliação por ultrassonografia cerebral, com má-formação do sistema nervoso central ou falecidos antes de 24 horas de vida. Os exames foram realizados através da fontanela anterior, utilizando-se ecógrafo Aloka ® 620 e transdutor de 5 mHz, entre o primeiro e o terceiro dia de vida, e também no sétimo e no 28º dia de vida e/ou na alta hospitalar. A incidência foi analisada pelo teste de qui-quadrado de tendência ou pelo Cochran-Armitage test, e pelo modelo de regressão linear simples (curva de tendência logarítmica). Para avaliação dos possíveis fatores associados, analisaram-se dados obstétricos, perinatais e neonatais nos períodos de 1991/1994 e 2002/2005, com cálculo do teste de qui-quadrado / Fisher e do risco relativo. O nível de significância foi de 5%.Resultados: Nasceram 1.777 crianças de muito baixo peso, e 1.381 (77,7%) foram avaliadas. Dessas, 289 (20,9%) apresentaram HPIV. A distribuição anual mostrou queda na incidência, de 50,9% em 1991 para 11...

Intraventricular haemorrhage in very preterm neonates

“…The cause of death in these babies was attributed to neonatal sepsis. 10,11 Multivariate analysis in present study showed that hypotension was significantly associated with IVH (OR 27.8; CI:1.64-470.8; p value 0.021). This was in consensus with a study done by Ballabh P in which hypotension was found to be a significant risk factor for IVH.…”

Avaliação do sistema nervoso auditivo central em neonatos com Hemorragia peri intraventricular

“…Over the years there is a significant drop in incidence of PIVH for all weight ranges. 2 PIVH occurs from the subependymal germinal matrix, the site of neuronal proliferation and origin of the tissue that support the brain. It is a highly vascularized region, but with vessels which present a fragile morphology.…”

Pesquisas em pneumologia recentemente publicadas em revistas brasileiras

“…In a study conducted in Brazil by da Silva et al, (30) 51 Rhodococcus equi isolates were identified in the sputum samples of 546 individuals suspected of having pulmonary tuberculosis. The authors described the epidemiology of the infection, as well as the phenotypic characteristics and drug susceptibility profile of the isolates.…”

“…The authors therefore suggested that strategies aimed at preventing decreased type V collagen synthesis or local responses that reduce Marba et al (51) studied the treatment of very-low-birth-weight neonates over a period of 15 years. The authors found that the incidence of periventricular/intraventricular hemorrhage declined significantly over the study period.…”