Risk Factors for Germinal Matrix Haemorrhage-Intraventricular Haemorrhage in Very Low Birth Weight Infants
Abstract
Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) mainly occurs in preterm neonates and is an important cause of brain injury in them. In this retrospective cross-sectional study from march 2017 to march 2018 in our teaching hospitals, we investigated 250 newborns who were admitted to NICU with a birth weight under 1500 grams with ultrasonographic study for presence and grade of GMH-IVH in their first week of life. Risk factors for GMH-IVH were collected from their records and results been analyzed with SPSS software. From 250 neonates who had inclusion criteria of the study, 22 cases had GMH-IVH in ultrasonographic evaluation. 37.6% of all cases and 31.8% of newborns with GMH-IVH had a 5-minute APGAR score of less than six. 91 cases (39.9%) of the control group and 15 cases (68.1%) of the GMH-IVH group need resuscitation at birth. Of 250 cases 54 (21.6%) died, that 14 cases (63.6%) had GMH-IVH. Our study shows significant differences for birth weight, 5 minute APGAR score, and the need for resuscitation at birth as risk factors for the development of GMH-IVH in very low birth weight neonates, but we do not find a significant difference group in terms of gestational age, gender, route of delivery, fetal presentation, maternal parity, CBC parameters, sepsis, RDS, endotracheal tube suctioning and multiple pregnancies for them. In our study, the protective value for antenatal steroid therapy depends on the completion of the course of treatment for mothers.
2. Sauer CW, Kong JY, Vaucher YE, Finer N, Proudfoot JA, Boutin MA, et al. Intubation attempts increase the risk for severe intraventricular hemorrhage in preterm infants—a retrospective cohort study. J Pediatr 2016;177:108-13.
3. Al-Abdi SY, Al-Aamri MA. A systematic review and meta-analysis of the timing of early intraventricular hemorrhage in preterm neonates: clinical and research implications. J Clin Neonatol 2014;3:76-88.
4. Kalani M, Shariat M, Khalesi N, Farahani Z, Ahmadi S. A comparison of early ibuprofen and indomethacin administration to prevent intraventricular hemorrhage among preterm infants. Acta Med Iran 2016;54:788-92.
5. Watson A, Saville B, Lu Z, Walsh W. It is not the ride: inter-hospital transport is not an independent risk factor for intraventricular hemorrhage among very low birth weight infants. J Perinatol 2013;33:366-70.
6. Lee HJ, Lee BS, Do HJ, Oh SH, Choi YS, Chung SH, et al. Early sodium and fluid intake and severe intraventricular hemorrhage in extremely low birth weight infants. J Korean Med Sci 2015;30:283-9.
7. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2017;3:CD004454.
8. Linder N, Haskin O, Levit O, Klinger G, Prince T, Naor N, et al. Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case-control study. Pediatrics 2003;111:e590-5.
9. Kent AL, Wright IM, Abdel-Latif ME. Mortality and adverse neurologic outcomes are greater in preterm male infants. Pediatrics 2012;129:124-31.
10. Mohamed MA, Aly H. Male gender is associated with intraventricular hemorrhage. Pediatrics 2010;125:e333-9.
11. Haque KN, Hayes AM, Ahmed Z, Wilde R, Fong CY. Caesarean or vaginal delivery for preterm very-low-birth weight (≤ 1,250 g) infant: experience from a district general hospital in UK. Arch Gynecol Obstet 2008;277:207-12.
12. Herbst A, Källén K. Influence of mode of delivery on neonatal mortality and morbidity in spontaneous preterm breech delivery. Eur J Obstet Gynecol Reprod Biol 2007;133:25-9.
13. Gamaleldin I, Harding D, Siassakos D, Draycott T, Odd D. Significant intraventricular hemorrhage is more likely in very preterm infants born by vaginal delivery: a multi-centre retrospective cohort study. J Matern Fetal Neonatal Med 2019;32:477-82.
14. Kaiser JR, Gauss CH, Pont MM, Williams DK. Hypercapnia during the first 3 days of life is associated with severe intraventricular hemorrhage in very low birth weight infants. J Perinatol 2006;26:279-85.
15. Vela-Huerta MM, Amador-Licona M, Medina-Ovando N, Aldana-Valenzuela C. Factors associated with early severe intraventricular haemorrhage in very low birth weight infants. Neuropediatrics 2009;40:224-7.
16. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010;126:443-56.
17. Bajwa NM, Berner M, Worley S, Pfister RE. Population based age stratified morbidities of premature infants in Switzerland. Swiss Med Wkly 2011;141:w13212.
18. Fellman V, Hellström-Westas L, Norman M, Westgren M, Källén K, Lagercrantz H, et al. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA 2009;301:2225-33.
19. Aly H, Hammad TA, Essers J, Wung JT. Is mechanical ventilation associated with intraventricular hemorrhage in preterm infants? Brain Dev 2012;34:201-5.
20. Beltempo M, Wintermark P, Lemyre B, Shalish W, Martel-Bucci A, Narvey M, et al. Predictors of severe neurologic injury on ultrasound scan of the head and risk factor-based screening for infants born preterm. J Pediatr 2019;214:27-33.
21. Kenet G, Kuperman AA, Strauss T, Brenner B. Neonatal IVH–mechanisms and management. Thromb Res 2011;127:S120-2.
| Files | ||
| Issue | Vol 59, No 7 (2021) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v59i7.7021 | |
| Keywords | ||
| Intraventricular hemorrhage Risk-factors Very low birth weight | ||
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