The Frequency of Intraventricular Hemorrhage and its Risk Factors


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Abstract

Background::Intraventricular hemorrhage (IVH) (is the most prevalent type of cerebrovascular accident in premature infants, which can result in lasting neurological complications. The aim of this study was to ascertain the frequency of IVH and its associated risk factors within our particular context.

Materials and Methods::This cross-sectional study was carried out in a tertiary neonatal intensive care unit of a maternal and neonatal hospital from September 2018 to August 2019. Premature infants under 34 weeks of age and with birth weighp < 0500 grams who did not have significant congenital anomalies participated in the study. A brain ultrasound was performed by a sonologist during the first week. The infants were subsequently categorized into two groups: those with and without IVH. A comparative analysis was conducted using the chi-square test and logistic regression. A significance level of p(<0.05 was considered statistically significant.

Results::Of the 205 premature infants who completed the study, IVH was reported in 107 cases (52.1%), of which 97.3% of ventricular hemorrhages were grade I and II and 2.7% accounted for severe bleeding (grade III and IV). Gestational age less than 28 weeks, weight less than 1000 g, vaginal delivery, asphyxia and resuscitation, history of intubation and mechanical ventilation, cord blood acidity, dopamine infusion, and history of fever and chorioamnionitis in the mother have been found to be significantly associated with increased risk of IVH (p(<0.001). Antenatal corticosteroids decreased the risk (OR=10.63).

Conclusion::In this study, IVH has been found to be common in infants under 1500 g of weight, but the severe form was low in frequency and was observed significantly in high-risk pregnancies.

About the authors

Mohsen Haghshenas-Mojaveri

Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences

Email: info@benthamscience.net

Forough Omran

Department of Obstetrics and Gynecology, Student Committee Research,, Babol University of Medical Sciences

Email: info@benthamscience.net

Soraya Khafri

Infertility and Reproductive Health Research Center, Health Research Institute,, Babol University of Medical Sciences

Email: info@benthamscience.net

Raheleh Mehraein

Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences,

Email: info@benthamscience.net

Ebrahim Hejazian

Clinical Research Development Unite, Babol University of Medical Sciences

Email: info@benthamscience.net

Zahra Akbarian-Rad

Non-Communicable Pediatric Disease Research Center, Babol university of medical sciences

Author for correspondence.
Email: info@benthamscience.net

References

  1. Egesa WI. Germinal matrix-intraventricular hemorrhage: A tale of preterm infants. Int J Pediatr 2021; 2021: 6622598. doi: 10.1155/2021/6622598
  2. Egwu CC, Ogala WN, Farouk ZL, Tabari AM, Dambatta AH. Factors associated with intraventricular hemorrhage among preterm neonates in Aminu Kano teaching hospital. Niger J Clin Pract 2019; 22(3): 298-304. doi: 10.4103/njcp.njcp_154_18 PMID: 30837415
  3. Valdez Sandoval P, Hernández Rosales P, Quiñones Hernández DG, Chavana Naranjo EA, García Navarro V. Intraventricular hemorrhage and posthemorrhagic hydrocephalus in preterm infants: diagnosis, classification, and treatment options. Childs Nerv Syst 2019; 35(6): 917-27. doi: 10.1007/s00381-019-04127-x PMID: 30953157
  4. Akbarian-rad Z, Ed. Intra ventricular hemorrhage: Frequency and outcomes at the time of discharge. Caspian journal of pediatrics 2022; 8(1): 657-3.
  5. Swaiman K, Ashwal S, Ferriero D, Eds. Pediatric Neurology: Principles and Practice. (4th ed..). Philadelphia: Mosby, Elsevier 2006; pp. 167-79.
  6. Mahaney KB, Buddhala C, Paturu M, Morales D, Limbrick DD Jr, Strahle JM. Intraventricular hemorrhage clearance in human neonatal cerebrospinal fluid: Associations with hydrocephalus. Stroke 2020; 51(6): 1712-9. doi: 10.1161/STROKEAHA.119.028744 PMID: 32397930
  7. Ahn SY, Chang YS, Sung SI, Park WS. Mesenchymal stem cells for severe intraventricular hemorrhage in preterm infants: Phase I dose-escalation clinical trial. Stem Cells Transl Med 2018; 7(12): 847-56. doi: 10.1002/sctm.17-0219 PMID: 30133179
  8. Li Q, Huang Y-J, Zhang G, et al. Intraventricular hemorrhage and early hematoma expansion in patients with intracerebral hemorrhage. Sci Rep 2015; 5(1): 11357. doi: 10.1038/srep11357 PMID: 26087142
  9. Szpecht D, Szymankiewicz M, Nowak I, Gadzinowski J. Intraventricular hemorrhage in neonates born before 32 weeks of gestation-retrospective analysis of risk factors. Childs Nerv Syst 2016; 32(8): 1399-404. doi: 10.1007/s00381-016-3127-x PMID: 27236782
  10. Samaei H. The incidence and grading of Intraventricular Hemorrhage (IVH) in premature babies. RJMS 1999; 5(1): 18-23.
  11. Kuperman AA, Kenet G, Papadakis E, Brenner B. Intraventricular hemorrhage in preterm infants: Coagulation perspectives. Semin Thromb Hemost 2011; 37(7): 730-6. doi: 10.1055/s-0031-1297163 PMID: 22187395
  12. Agha Ghazvieny L. Ultrasonic findings of intraventricular hemorrhage in preterm newborns in Shariati Hospital (1391-1392). AUMJ 2016; 5(3): 137-48.
  13. Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994. Pediatrics 2000; 105(6): 1216-26. doi: 10.1542/peds.105.6.1216 PMID: 10835060
  14. Resch B, Gedermann A, Maurer U, Ritschl E, Müller W. Neurodevelopmental outcome of hydrocephalus following intra-/periventricular hemorrhage in preterm infants: Short- and long-term results. Childs Nerv Syst 1996; 12(1): 27-33. doi: 10.1007/BF00573851 PMID: 8869171
  15. Shipley L, Gyorkos T, Dorling J, Tata LJ, Szatkowski L, Sharkey D. Risk of severe intraventricular hemorrhage in the first week of life in preterm infants transported before 72 hours of age. Pediatr Crit Care Med 2019; 20(7): 638-44. doi: 10.1097/PCC.0000000000001937 PMID: 31013263
  16. Gilard V, Chadie A, Ferracci F-X, et al. Post hemorrhagic hydrocephalus and neurodevelopmental outcomes in a context of neonatal intraventricular hemorrhage: An institutional experience in 122 preterm children. BMC Pediatr 2018; 18(1): 288. doi: 10.1186/s12887-018-1249-x PMID: 30170570
  17. Ballabh P. Intraventricular hemorrhage in premature infants: Mechanism of disease. Pediatr Res 2010; 67(1): 1-8. doi: 10.1203/PDR.0b013e3181c1b176 PMID: 19816235
  18. Lee JY, Kim HS, Jung E, et al. Risk factors for periventricular-intraventricular hemorrhage in premature infants. J Korean Med Sci 2010; 25(3): 418-24. doi: 10.3346/jkms.2010.25.3.418 PMID: 20191041
  19. Bozkaya D, Ceran B, Ozmen E, et al. A new hope in the treatment of intraventricular haemorrhage in preterm infants: Mesenchymal stem cells. Turk Neurosurg 2022; 32(2): 344-6. PMID: 34936069
  20. Herzog M, Cerar LK, Sršen TP, Verdenik I, Lučovnik M. Impact of risk factors other than prematurity on periventricular leukomalacia. A population-based matched case control study. Eur J Obstet Gynecol Reprod Biol 2015; 187: 57-9. doi: 10.1016/j.ejogrb.2015.02.008 PMID: 25748489
  21. Sajjadian N, Fakhrai H, Jahadi, R. Incidence of intraventricular hemorrhage and post hemorrhagic hydrocephalus in preterm infants. Acta Medica Iranica 2010; 48(4): 260-62.
  22. Bolisetty S, Dhawan A, Abdel-Latif M. et al. Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants. Pediatrics 2014; 133(1): 55-62. doi: 10.1542/peds.2013-0372 PMID: 24379238
  23. Roberts JC, Javed M J, Hocker JR, Wang H, Tarantino MD. Risk factors associated with intraventricular hemorrhage in extremely premature neonates. Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis 2018; 29(1): 25-9. doi: 10.1097/MBC.0000000000000661
  24. Harris DL, Teele RL, Bloomfield FH, Harding JE. Does variation in interpretation of ultrasonograms account for the variation in incidence of germinal matrix/intraventricular haemorrhage between newborn intensive care units in New Zealand? Arch Dis Child Fetal Neonatal Ed 2005; 90(6): F494-9.
  25. Dyet LE, Kennea N, Counsell SJ. et al. Natural history of brain lesions in extremely preterm infants studied with serial magnetic resonance imaging from birth and neurodevelopmental assessment. Pediatrics 2006; 118(2): 536-48.
  26. Jodeiry B, Heidarzadeh M, Sahmani-Asl S. et al. Study of intraventricular hemorrhage in VLBW neonates admitted in Al-Zahra Hospital, Tabriz, Iran. Niger J Med 2012; 21(1): 92-7. PMID: 23301457
  27. Helwich E, Rutkowska M, Bokiniec R, Gulczyńska E, Hożejowski R. Intraventricular hemorrhage in premature infants with Respiratory Distress Syndrome treated with surfactant: incidence and risk factors in the prospective cohort study. Med Wieku Rozwoj 2017; 21(4): 328-5.
  28. Johnson S. Randomized trial of a parenting intervention for very preterm infants: Outcome at 2 years. J Pediatr 2009; 155(4): 488-94.
  29. Abdul Aziz AN. Early inotrope use associated with higher risk of death and/or severe brain injury in extremely premature infants. J Matern -Fetal Neonatal Med 2018; 1-191.
  30. Vesoulis ZA, Ters NE, Foster A, Trivedi SB, Liao SM, Mathur AM. Response to dopamine in prematurity: a biomarker for brain injury? J Perinatol 2016; 36(6): 453-58. doi: 10.1038/jp.2016.5
  31. Poryo M, Boeckh JC, Gortner L. Ante-, peri- and postnatal factors associated with intraventricular hemorrhage in very premature infants. Early Hum Dev 2018; 116: 1-8. doi: 10.1016/j.earlhumdev.2017.08.010 PMID: 29091782

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