Peri/intraventricular haemorrhage: a cranial ultrasound study on 5286 neonates

Berger, Richard E.; Bender, Steffen; Sefkow, S.; Klingmüller, V.; Künzel, W.; Jensen, Arne

doi:10.1016/s0301-2115(97)00135-8

Cited by 52 publications

(56 citation statements)

References 24 publications

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“…It is proposed that low oxygen tension (hypoxia) followed by periods of reoxygenation is the more likely stimulus for excess oxygen free radicals 27. This hypothesis is reinforced by the fact that in immature neonates, the incidence and severity of IVH are highly associated with low Apgar scores at birth 2. Our study suggests a doubling of the risk of ROP (stage 3 +) in high grade IVH compared with low grade IVH (20% v 10%), but the study had inadequate power (<60% power) to detect a real difference of this magnitude as statistically significant.…”

Section: Discussionmentioning

confidence: 99%

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Ocular significance of intraventricular haemorrhage in premature infants

O’Keefe¹,

Kafil-Hussain²,

Flitcroft³

et al. 2001

British Journal of Ophthalmology

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(Br J Ophthalmol 2001;85:357-359) Intraventricular haemorrhage (IVH) is a common complication associated with prematurity. 1 The incidence of IVH increases progressively with decreasing gestational age-for example, from 1.6% at 38-43 weeks up to 50% at 24-30 weeks of gestation.2 Despite advances in neonatal critical care, 21% of infants weighing less than 1000 g and 12% of those weighing less than 1500 g were aVected.3 Important neurological complications are periventricular leucomalacia and post-haemorrhagic hydrocephalus.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of IVH increases progressively with decreasing gestational age—for example, from 1.6% at 38–43 weeks up to 50% at 24–30 weeks of gestation 2. Despite advances in neonatal critical care, 21% of infants weighing less than 1000 g and 12% of those weighing less than 1500 g were affected 3.…”

mentioning

confidence: 99%

Ocular significance of intraventricular haemorrhage in premature infants

O’Keefe¹,

Kafil-Hussain²,

Flitcroft³

et al. 2001

British Journal of Ophthalmology

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“…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). …”

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confidence: 99%

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

Coumans

Middelanis²,

Garnier³

et al. 2003

Pediatr Res

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Perinatal brain damage is associated not only with hypoxicischemic insults but also with intrauterine inflammation. A combination of antenatal inflammation and asphyxia increases the risk of cerebral palsy Ͼ70 times. The aim of the present study was to determine the effect of intracisternal (i.c.) administration of endotoxin [lipopolysaccharides (LPS)] on subsequent hypoxic-ischemic brain damage in neonatal rats. Seven-day-old Wistar rats were subjected to i.c. application of NaCl or LPS (5 g/pup). One hour later, the left common carotid artery was exposed through a midline neck incision and ligated with 6-0 surgical silk. After another hour of recovery, the pups were subjected to a hypoxic gas mixture (8% oxygen/92% nitrogen) for 60 min. The animals were randomized to four experimental groups: 1) sham control group, left common carotid artery exposed but not ligated (n ϭ 5); 2) LPS group, subjected to i.c. application of LPS (n ϭ 7); 3) hypoxic-ischemic study group, i.c. injection of NaCl and exposure to hypoxia after ligation of the left carotid artery (n ϭ 17); or 4) hypoxic-ischemic/LPS study group, i.c. injection of LPS and exposure to hypoxia after ligation of the left carotid artery (n ϭ 19). Seven days later, neonatal brains were assessed for neuronal cell damage. In a second set of experiments, rat pups received an i.c. injection of LPS (5 g/pup) and were evaluated for tumor necrosis factor-␣ expression by immunohistochemistry. Neuronal cell damage could not be observed in the sham control or in the LPS group. In the hypoxicischemic/LPS group, neuronal injury in the cerebral cortex was significantly higher than in animals that were subjected to hypoxia/ischemia after i.c. application of NaCl. Injecting LPS intracisternally caused a marked expression of tumor necrosis factor-␣ in the leptomeninges. Applying LPS intracisternally sensitizes the immature rat brain to a subsequent hypoxicischemic insult. Hypoxic-ischemic cerebral damage is an important contributor to perinatal mortality and morbidity, including long-term neurologic sequelae in term and preterm fetuses (1, 2). However, as shown in recent studies, perinatal brain injury may be associated not only with hypoxic-ischemic insults but also with an ascending intrauterine inflammation before or during birth (3). It is widely known that Gram-negative anaerobic bacteria are involved in colonization and infection of the genitourinary tract in pregnant women, which could affect labor and preterm birth. Because pregnant women with fever and bacteriuria give birth to infants with a higher incidence of neurologic defects at 1 y of age than do mothers who are free of urinary tract infection (4), it seems that human maternal endotoxemia is associated with fetal CNS damage. Furthermore, there is a growing body of evidence from epidemiologic studies that exposure to placental inflammation before or during birth is accompanied by cerebral white matter damage, especially in the very preterm fetuses, i.e. those born before 32 wk of gestation (3). In addition, the ...

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“…Indeed, most authorities agree that the majority of cases of IVH do occur early on the first postnatal day or within the first few days of life. 2,18 There are limitations to this study. First, it is an observational study making use of predefined variables collected for a previous study on the association of thrombocytopenia and delivery method with IVH.…”

Section: Commentsmentioning

confidence: 95%

Inter-NICU Variation in Rates and Management of Thrombocytopenia among Very Low Birth-Weight Infants

2003

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OBJECTIVES:To investigate variation among neonatal intensive care units (NICUs) in prevalence and management of thrombocytopenia in infants <1500 g. STUDY DESIGN:In total 1283 infants <1500 g admitted to six NICUs over 21 months were prospectively analyzed. Illness severity was measured by the Score for Neonatal Acute Physiology (SNAP). Platelet counts in the first 12 hours after birth and on day 3 of life were abstracted from the infants' medical records. Thrombocytopenia was determined from the lowest platelet count in each of these time periods. RESULTS:There was variability in rates of thrombocytopenia among NICUs, even after controlling for risk factors (e.g., SNAP, small for gestational (SGA) age and maternal hypertension). One site had a high prevalence of thrombocytopenia, but the lowest percentage of infants with thrombocytopenia who received platelet transfusions. After controlling for SNAP, GA, SGA, Apgar score and incidence of thrombocytopenia, the odds of receiving platelets at this site, relative to the site with the highest transfusion rate, was 0.10 (95% CI 0.02 to 0.43). CONCLUSIONS:This multicenter study finds a 10-fold variation among NICU in the administration of platelets to their thrombocytopenic infants that cannot be explained by presence of thrombocytopenia or illness severity.

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Peri/intraventricular haemorrhage: a cranial ultrasound study on 5286 neonates

Cited by 52 publications

References 24 publications

Ocular significance of intraventricular haemorrhage in premature infants

Ocular significance of intraventricular haemorrhage in premature infants

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

Inter-NICU Variation in Rates and Management of Thrombocytopenia among Very Low Birth-Weight Infants

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