Risk factors for intraventricular hemorrhage in a birth cohort of 3721 premature infants

Gleißner, M.; Jorch, Gerhard; Avenarius, Stefan

doi:10.1515/jpm.2000.013

Cited by 67 publications

(56 citation statements)

References 15 publications

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“…1,4,5,6,23,24,25,26 This study's mortality rates were similar to rates found in other institutions 27 . Though this study was carried out over a short period of time with a small sample size, our results suggest a reduction in overall mortality in non-NICU-TM hospitals (Table 2).…”

Section: Discussionsupporting

confidence: 88%

“…Morbidity, including grades 3 and 4 IVH and chronic lung disease, are also somewhat more common in neonates that require transport after delivery. 27,28,29 Continued barriers to regionalization have not been consistently well described and clinicians in several locales have attempted to regionalize perinatal care with varying degrees of success. In many states, regionalization efforts were beneficial, were often supported by solid data and, at minimum, displayed a degree of progress.…”

Section: Discussionmentioning

confidence: 99%

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Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Kim

Teague-Ross

Greenfield

et al. 2014

Obstetrical &Amp; Gynecological Survey

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OBJECTIVES-We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth-weight (VLBW, <1500 grams) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality.STUDY DESIGN-This prospective study used obstetrical and neonatal interventions through TM consults, education, and census rounds with 9 hospitals from July 1, 2009 -March 31, 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality, and morbidity before and after TM use. Arkansas Health Department data and chi square analysis were used to compare infant mortality.RESULTS-Deliveries of VLBW neonates in targeted hospitals decreased from 13.1% to 7.0% (p=0.0099); deliveries of VLBW neonates in remaining hospitals was unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (p=0.043).CONCLUSIONS-TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality..

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Kim

Teague-Ross

Greenfield

et al. 2014

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

show abstract

“…A number of risk factors have been proposed for the development of IVH: low birth weight and gestational age, [1][2][3][4][5][6][7][8] maternal smoking, 9 breech presentation, 5 gender, 5,7,10 premature rupture of membranes, 6,11 intrauterine infection, 6,11-13 mode of delivery, 5,10,11,14,15 prolonged labor, 1,16 postnatal resuscitation and intubation, 1,7,16 transferal from one unit to another, 7,16 early onset of sepsis, 17,18 development of respiratory distress syndrome 7,11 or pneumothorax, 2 recurrent endotracheal suctioning, 1,16 metabolic acidosis and rapid bicarbonate infusion, 10,16 and high-frequency ventilation. 19 Pregnancy-induced hypertension is associated with a lower rate of IVH.…”

mentioning

confidence: 99%

Risk Factors for Intraventricular Hemorrhage in Very Low Birth Weight Premature Infants: A Retrospective Case-Control Study

et al. 2003

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ABSTRACT. Objective. High-grade intraventricular hemorrhage (IVH) is an important cause of severe cognitive and motor neurologic impairment in very low birth weight infants and is associated with a high mortality rate. The risk of IVH is inversely related to gestational age and birth weight. Previous studies have proposed a number of risk factors for IVH; however, lack of adequate matching for gestational age and birth weight may have confounded the results. The purpose of this study was to identify variables that affect the risk of high-grade IVH, using a retrospective and case-control clinical study.Methods. From a cohort of 641 consecutive preterm infants with a birth weight of <1500 g, 36 infants with IVH grade 3 and/or 4 were identified. A control group of 69 infants, closely matched for gestational age and birth weight, was selected. Maternal factors, labor and delivery characteristics, and neonatal parameters were collected in both groups. Results of cranial ultrasound examinations, whether routine or performed in presence of clinical suspicion, were also collected. Univariate analysis and multivariate logistic regression analysis were performed.Results. High fraction of inspired oxygen in the first 24 hours, pneumothorax, fertility treatment (mostly in vitro fertilization), and early sepsis were associated with an increased risk of IVH. A higher number of suctioning procedures, a higher first hematocrit, and a relatively low arterial pressure of carbon dioxide during the first 24 hours of life were associated with a lower occurrence. In the multivariate logistic regression model, early sepsis (odds ratio [

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“…Cerebral white matter injury is responsible for considerable morbidity in infants born prematurely (1)(2)(3)(4)(5). The two principal underlying brain lesions are HPI and cystic PVL (6).…”

mentioning

confidence: 99%

Postnatal Changes in Cerebral Oxygen Extraction in the Preterm Infant Are Associated with Intraventricular Hemorrhage and Hemorrhagic Parenchymal Infarction but Not Periventricular Leukomalacia

et al. 2004

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Fluctuations in cerebral hemodynamics have been implicated in the pathogenesis of acquired brain damage in babies born prematurely. This study examined the changes in cerebral fractional oxygen extraction (FOE) over the first 3 d after birth in 25 verylow-birth-weight preterm infants. Twelve infants had no major cerebral injury and 13 had acquired brain injury; cystic periventricular leukomalacia (PVL) was present in 4 and intraventricular hemorrhage (IVH) in 9, of whom 2 also had hemorrhagic parenchymal infarction (HPI). Normal values (median, 5 th -95 th centiles) for cerebral FOE in very-low-birth-weight infants with no cerebral injury were 0. Cerebral white matter injury is responsible for considerable morbidity in infants born prematurely (1-5). The two principal underlying brain lesions are HPI and cystic PVL (6). Abnormal cerebral hemodynamics and oxygen delivery have been suggested as possible etiological factors for both lesions (7). Increased variability in cerebral blood flow or mean arterial blood pressure have been associated with the development of IVH (8 -11). By contrast, cystic PVL has been attributed to cerebral hypoperfusion (8,(12)(13)(14). Other studies, however, have demonstrated no relationship between the incidence of PVL and hypotension (15-17). There is also emerging evidence to implicate infection and inflammation, and the vulnerability of the oligodendrocyte precursors that inhabit the developing periventricular white matter, in the etiology of PVL (18 -24).Another variable that is related to cerebral perfusion and oxygen delivery is cerebral FOE, which represents the ratio of cerebral oxygen consumption to cerebral oxygen delivery. As oxygen delivery decreases, FOE would be expected to increase so that oxygen consumption remains constant. When oxygen delivery decreases beyond the critical point at which oxygen extraction is maximal and cannot increase further, oxygen consumption will start to decrease. This present study was undertaken to investigate the patterns of change in cerebral FOE over the first 3 d after birth in preterm, very-low-birthweight neonates, and to relate these changes to acquired cerebral injury. The hypothesis that was tested was that infants with no major cerebral injury would exhibit a different pattern of Received February 18, 2003; accepted September 9, 2003

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Risk factors for intraventricular hemorrhage in a birth cohort of 3721 premature infants

Abstract: The frequency of IVH could be reduced significantly, if extremely premature infants, the vast majority of patients suffering from IVH, did not have to be transferred postnatally to another hospital.

Cited by 67 publications

References 15 publications

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Risk Factors for Intraventricular Hemorrhage in Very Low Birth Weight Premature Infants: A Retrospective Case-Control Study

Postnatal Changes in Cerebral Oxygen Extraction in the Preterm Infant Are Associated with Intraventricular Hemorrhage and Hemorrhagic Parenchymal Infarction but Not Periventricular Leukomalacia

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