Risk Factors for Periventricular-Intraventricular Hemorrhage in Premature Infants

Lee, Ju Young; Kim, Han Suk; Jung, Euiseok; Kim, Eun Sun; Shim, Gyu Hong; Lee, Hyun Joo; Lee, Jin A; Choi, Chang Won; Kim, Ee Kyung; Kim, Beyong Ii; Choi, Jung Hwan

doi:10.3346/jkms.2010.25.3.418

Cited by 56 publications

(45 citation statements)

References 29 publications

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“…The systemic blood pressure becomes the primary determinant of cerebral blood flow and pressure, which is a pressurepassive circulatory situation, in the absence of autoregulation. Rapid volume expansion with blood products or hypertonic solutions and excessive use of inotropes for the correction of hypotension results in a rapid increase of cerebral blood flow and can cause injury to the fragile germinal matrix capillaries [34,35]. In this study, we could not find any association of the use of inotropes with low-grade IVH.…”

Section: Discussioncontrasting

confidence: 43%

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Peixoto

Amaral

Resende

et al. 2018

Sci Med

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AIMS: To evaluate the impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in preterm infants at 24 months of age. METHODS: We conducted a retrospective case-control study of infants with gestational age less than 34 weeks, admitted to a Neonatal Intensive Care Unit between January/2006 and December/2015. Cases were defined as those with low-grade intraventricular hemorrhage (grades I or II), diagnosed by cranial ultrasonography. For each case, a control with the same gestational age but without intraventricular hemorrhage was selected. Follow-up examinations of neurodevelopment were performed at 24 months of age in cases and controls using the Griffiths Mental Development Scale. Cerebral palsy, neurodevelopmental delay (developmental quotient <2 side deviations below the mean), hearing impairment and/or blindness were considered as severe neurodevelopmental impairment. RESULTS: The study included 172 preterm infants: 86 cases and 86 controls. In the univariate analysis, a difference between the two groups was identified for the following clinical findings: antenatal corticosteroid complete cycle (57% in cases vs. 80% in controls; p=0.001; OR: 0.33, 95%CI 0.17-0.64); male gender (63% cases vs. 41% controls; p=0.004; OR: 2.45, 95%CI 1.3-4.5); outborn (26% cases vs. 9% controls; p=0.005; OR: 3.3 95%CI 1.4-8.0); Clinical Risk Index for Babies higher than 5 (24% in cases vs. 12% in controls; p=0.029; OR: 2.4 95%CI 1.1-5.6); intubation in the delivery room (47% cases vs. 27% controls; p=0.007; OR: 2.38 95%CI 1.3-4.5); and neonatal sepsis (34% in cases vs. 20% in controls; p=0.039; OR: 2.1 95%CI 1.03-4.1). After logistic regression, differences were only maintained for antenatal corticosteroid (p=0.005; OR 0.34, 95%CI 0.16-0.72) and male gender (p=0.002; OR 2.9, 95%CI 1.4-5.8). A severe neurodevelopmental deficit was present in three cases (3.5%) and one control (1.2%). No statistically significant differences in outcome were found between cases and controls. CONCLUSIONS: In this sample, preterm infants with low-grade intraventricular hemorrhage diagnosed by cranial ultrasonography had no difference in early neurodevelopmental outcome when compared with controls.KEYWORDS: cerebral intraventricular hemorrhage; preterm infant; neurodevelopmental disorders. RESUMOOBJETIVOS: Avaliar o impacto da hemorragia intraventricular de baixo grau no neurodesenvolvimento de lactentes prematuros aos 24 meses de idade. MÉTODOS: Foi conduzido um estudo de caso-controle retrospectivo em lactentes com idade gestacional inferior a 34 semanas, internados em uma Unidade de Terapia Intensiva Neonatal entre janeiro de 2006 e dezembro de 2015. Os casos foram definidos como aqueles com hemorragia intraventricular de baixo grau (graus I ou II), diagnosticada por ultrassonografia craniana. Para cada caso, foi selecionado um controle com a mesma idade gestacional, mas sem hemorragia intraventricular. A avaliação do neurodesenvolvimento foi realizada aos 24 meses de idade, em casos e controles, com a Escala de Desen...

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Section: Discussioncontrasting

confidence: 43%

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Peixoto

Amaral

Resende

et al. 2018

Sci Med

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“…13 Sarkar S et al and Lee J Y et al also showed in their studies that neonatal sepsis is a major risk factor for IVH. 14,15 It was also shown by Adegoke SA et al that neonatal sepsis brings an increased risk for IVH in VLBW babies. 16 Hence neonatal sepsis and hypotension in these preterm babies pose the infant at great risk of intraventricular haemorrhage which increases the morbidity and mortality in this population significantly.…”

Section: Outcomementioning

confidence: 96%

Intraventricular haemorrhage in very preterm neonates

Kapoor

Sharma

Sapare³

et al. 2018

Int J Contemp Pediatr

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Background: The objective of the current study was to evaluate the incidence of intraventricular haemorrhage and its associated risk factors in preterm neonates.Methods: This cohort study done at Neonatal Intensive Care Unit of a tertiary care hospital in south India enrolled 104 preterm neonates with either gestational age <32weeks and/or birth weight <1500 grams at birth. These babies were serially screened for intraventricular haemorrhage by doing a neurosonogram on day3 and day 14 of life.Results: Incidence of IVH was found to be 18.2%. Amongst these cases 52.6% babies had Grade I, 36.8% babies had Grade II and 10.6% babies had Grade III intraventricular hemorrhage with ventriculomegaly, as per Papile grading system. It was seen that hypotension needing use of inotropes and neonatal sepsis were significantly associated with IVH.Conclusions: The incidence of IVH in babies born with gestational age <32weeks and/or birth weight <1500 grams was 18.2% in our study. Neonatal sepsis and hypotension requiring use of inotropes were found to be the significant risk factors in this population.

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“…Son yıllarda, teknolojik gelişmeler, yenidoğan yoğun bakım şartlarının iyileştirilmesiyle yaşatılan çok küçük prematüre bebeklerin sayısı artmakta, intrakraniyal kanama (İKK) sıklığı azalsa da bir sorun olarak önemini korumaktadır (1,2) . Yenidoğan döneminde en sık saptanan İKK, periventriküler/intraventriküler kanama (PV/İVK) olup, sıklıkla prematüre bebeklerde görülmektedir.…”

Section: Introductionunclassified

“…Yenidoğan döneminde en sık saptanan İKK, periventriküler/intraventriküler kanama (PV/İVK) olup, sıklıkla prematüre bebeklerde görülmektedir. Bu kanamalar sıklıkla lateral ventriküllerin subepandimal tabakasını oluştu-ran germinal matriks (GM) kısmında görülmektedir (1,2) . PV/İVK'da en önemli risk faktörleri prematüre doğum ve düşük doğum ağırlığıdır (2) .…”

Section: Introductionunclassified

“…Bu kanamalar sıklıkla lateral ventriküllerin subepandimal tabakasını oluştu-ran germinal matriks (GM) kısmında görülmektedir (1,2) . PV/İVK'da en önemli risk faktörleri prematüre doğum ve düşük doğum ağırlığıdır (2) . PV/İVK sıklık-la postnatal ilk hafta içinde, bunların da büyük çoğunluğu ilk 72 saatte gelişmektedir (3) .…”

Section: Introductionunclassified

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Risk factors of newborns with periventricular/intraventricular hemorrhage

Özdemir¹,

Gürses²,

Küçüktaşçi³

et al. 2015

Buch

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ÖZETAmaç: Yenidoğan döneminde en sık görülen intrakranial kanama, periventriküler/ intraventriküler kanama (PV/İVK)'dır. Prematürelerde PV/İVK önemli nörogelişim-sel sorunlara, hatta ölüme neden olabilmektedir. Yöntemler: Bu çalışmada, yenidoğan yoğun bakım ünitemizde hasta başı kraniyal ultrasonografi (US) ile PV/İVK saptanan 24 olguda predispozan risk faktörleri retrospektif olarak araştırıldı. Bulgular: Ventilatör tedavisi (%87,5), 5. dk. Apgar skorunun <7 olması (%83.3), respiratuar distres sendromu (RDS, %79.1), patent duktus arteriozus (PDA, %66.6), erken neonatal sepsis (%66.6), antenatal steroid uygulanmaması (%54.1), asfiksi (%33.3), erken membran rüptürü (%25), intrauterin gelişme geriliği (%25) ve trombositopeni (%25) predispozan risk faktörleri olarak saptandı. PV/İVK saptanan bebeklerin yedisi (%29.2) yenidoğan döneminde kaybedildi. Kaybedilen bebeklerin %71.4'ü ≤1500 g ve %85.7'si ≤32 hafta idi. Sonuç: Gebelik yaşı (≤32 hafta), doğum ağırlığı (≤1500 g), Apgar skoru (<7) düşüklü-ğü, antenatal steroid uygulanmaması, RDS, PDA, sepsis ve ventilatör tedavisi PV/ İVK için önemli risk faktörleridir. Böyle bebeklerin kraniyal US ile değerlendirilmesi ve kanama saptananların yakın takibi gerekmektedir. Anahtar kelimeler:Periventriküler/intraventriküler kanama, yenidoğan, risk faktörleri ABSTRACT Objective: Periventricular/intraventricular hemorrhage (PV/IVH) is the most common type of intracranial hemorrhage in the neonatal period. PV/IVH may cause significant neurodevelopmental problems for preterms, even it can be fatal. Low-birth weight and gestational age are the most important risk factors. Methods: In this study, predisposing risk factors were investigated by bedside cranial ultrasonography in 24 patients with PV/IVH in our neonatal intensive care unit retrospectively. Results: Predisposing risk factors were determined as need for ventilator therapy (87.5%), 5 th minute Apgar score <7 (83.3%), respiratory distress syndrome (RDS, 79.1%), patent ductus arteriosus (PDA, 66.6%), early neonatal sepsis (66.6%), nonuse of antenatal steroids (54.1%), asphyxia (33.3%), thrombocytopenia (25%), early rupture of membranes (25%) and intrauterine growth retardation (25%). Seven (29.2%) infants died during neonatal period, while 71.4% of them were ≤1500 g and 85.7% were ≤32GWs. Conclusion: Low gestational age (≤32GWs) and birth weight (≤1500 g), nonuse of antenatal steroids, low Apgar score, RDS, PDA, sepsis and need for ventilator therapy are important risk factors for PV/IVH. The newborns having predisposing risk factors should be evaluated by cranial US and infants diagnosed with intracranial bleeding should be closely monitoring.

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Risk Factors for Periventricular-Intraventricular Hemorrhage in Premature Infants

Cited by 56 publications

References 29 publications

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

Intraventricular haemorrhage in very preterm neonates

Risk factors of newborns with periventricular/intraventricular hemorrhage

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