Uso antenatal do corticosteroide e hemorragia peri-intraventricular

Vinagre, Luís Eduardo de Figueiredo; Marba, Sérgio Tadeu Martins

doi:10.1590/s0103-05822010000300014

Cited by 2 publications

(2 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mechanisms by which corticosteroids decrease the risk of hemorrhage are unclear, but they appear to be independent of enhanced pulmonary maturation. The postulated effects include an anti-angiogenic effect with inhibition of micro vessel morphogenesis in the germinal matrix capillary network and stabilization of the microvasculature of the developing germinal matrix [29]. Our data support the association between antenatal steroids and decreased risk of IVH.…”

Section: Discussionsupporting

confidence: 80%

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

Peixoto

Amaral

Resende

et al. 2018

Sci Med

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionsupporting

confidence: 80%

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

Peixoto

Amaral

Resende

et al. 2018

Sci Med

View full text Add to dashboard Cite

show abstract

“…10,17 O mecanismo pelo qual os corticoides antenatais têm um efeito protetor na redução do risco de HPIV pode dever-se a uma ação multifatorial: a aceleração da maturidade pulmonar, com consequente diminuição dos distúrbios respiratórios, promovendo assim maior estabilidade no fluxo sanguíneo cerebral, e a estimulação da maturação da microvasculatura da matriz germinativa, são algumas das razões apontadas. 33 Como descrito noutros estudos, o género masculino revelou-se um fator de risco para HPIV. 34 Esta associação tem sido atribuída a melhor maturação neurovascular e aos mecanismos de regulação cerebral no género feminino.…”

Section: Discussionunclassified

Hemorragia Peri-Intraventricular Grave em Prematuros: Impacto na Mortalidade e no Neurodesenvolvimento aos 24 Meses

et al. 2022

View full text Add to dashboard Cite

Introduction: Severe peri-intraventricular haemorrhage has been associated with higher mortality and neurodevelopmental impairment. The impact of peri-intraventricular haemorrhage alone (without white matter injury) remains controversial. The aim of this study was to evaluate the influence of severe peri-intraventricular haemorrhage, associated or not with cystic peri-ventricular leukomalacia, on mortality and neurodevelopment at 24 months.Material and Methods: Retrospective cohort study, that included newborns with severe peri-intraventricular haemorrhage admitted to a maternity hospital with differentiated perinatal support between 2006 and 2015, and two controls with the same gestational age, without peri-intraventricular haemorrhage, who were admitted immediately after the case. Neurodevelopmental assessment, at 24 months, was performed in 99 children, using the Schedule of Growing Skills II scale in 52 and the Ruth Griffiths mental development scale in 47 children. Severe neurodevelopmental deficit was diagnosed in the following conditions: cerebral palsy, delayed psychomotor development, deafness requiring hearing aids and blindness.Results: The study included 41 cases and 82 controls. Out of these, 23 died, 16 (39.0%) in the group of severe peri-intraventricular haemorrhage and seven (8.5%) in the control group (OR 7.6, 95% CI 2.6 - 20.4, p < 0.001). Severe neurodevelopmental deficit was diagnosed in seven (30.4%) in the severe peri-intraventricular haemorrhage group and one (1.3%) in the control group (OR 32; 95% CI 3.7 - 281, p < 0.001). Individualized analysis showed that mortality was higher in peri-intraventricular haemorrhage grade III with associated cystic peri-ventricular leukomalacia (OR 4.4 95% CI 1.3 - 14.2, p = 0.015) and in peri-intraventricular haemorrhage IV (OR 12; 95% CI 3.5 - 41.2, p < 0.001), when compared to controls. Differences were also noticed regarding severe neurodevelopmental deficit when compared with controls (1.3%) in grade III peri-intraventricular haemorrhage with associated cystic peri-ventricular leukomalacia, (75.0%, p < 0.001) and grade IV peri-intraventricular haemorrhage (50.0%, p < 0.001 ).Discussion: This work showed a higher mortality rate and neurodevelopment impairment in preterm newborns with severe peri-ventricular haemorrhage. Analysis by groups stratified according to gestational age and different grades of peri-ventricular haemorrhage displayed the complications associated with peri-ventricular haemorrhage grade IV or grade III, with or without cystic peri-ventricular leukomalacia.Conclusion: Preterm newborns with peri-intraventricular haemorrhage grade IV or grade III with cystic peri-ventricular leukomalacia, had a higher risk of mortality and severe neurodevelopmental impairment.

show abstract

Uso antenatal do corticosteroide e hemorragia peri-intraventricular

Cited by 2 publications

References 40 publications

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

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

Hemorragia Peri-Intraventricular Grave em Prematuros: Impacto na Mortalidade e no Neurodesenvolvimento aos 24 Meses

Contact Info

Product

Resources

About