Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 1, January-February, p. 89–94

doi: 10.17219/acem/65311

Publication type: original article

Language: English

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Intraventricular hemorrhage in neonates born from 23 to 26 weeks of gestation: Retrospective analysis of risk factors

Dawid Szpecht1,A,B,C,D, Irmina Nowak2,B,D, Paulina Kwiatkowska2,B,D, Marta Szymankiewicz1,E, Janusz Gadzinowski1,E,F

1 Chair and Department of Neonatology, Poznan University of Medical Sciences, Poland

2 Student Scientific Group of Perinatal Medicine, Poznan University of Medical Sciences, Poland

Abstract

Background. The study aim was to determine the incidence and analyze risk factors of IVH stage 3 and 4 in infants born before 26 weeks of gestation.
Objectives. A retrospective analysis of 110 preterm babies (23–26 weeks of gestation) hospitalized from 2009 to 2014 at the Department of Neonatology of Poznan University of Medical Sciences was performed.
Material and Methods. In the study group there were 29 (26.4%) children in the 23rd–24th weeks of pregnancy and 81 (73.6%) in the 25th–26th weeks of gestation.
Results. Among IVH stage 3 and 4 in neonates without prenatal steroids therapy, OR was 1.616 (1.059– 2.456; p = 0.022) for children born in the 23rd–24th week of gestation and 1.677 (1.001–2.809; p = 0.047) for children born in the 25th–26th week of pregnancy. An analysis of various risk factors revealed the chance of the appearance IVH stage 3 and 4 among neonates born in the 23th–24th and 25th–26th week of gestation rising only among those children who were treated for hypotension with catecholamines (OR 2.031 (0.269–24.21), p = 0.033 and OR 1.989 (0.224–16.55), p = 0.024).
Conclusion. The lower the gestational age, the more frequent the risk of IVH stage 3 and 4. The use of appropriate prophylaxis of perinatal patients (steroids in all pregnant women at risk of preterm birth, limiting the indications for the use of catecholamines for hypotension treatment) reduces the incidence of severe IVH.

Key words

risk factors, intraventricular hemorrhage, preterm neonates

References (20)

  1. Allen KA. Treatment of intraventricular hemorrhages in premature infants: Where is the evidence? Adv Neonatal Care. 2013;13:127–130.
  2. Bassan H. Intracranial hemorrhage in the preterm infant: Understanding it, preventing it. Clin Perinatol. 2009;36:737–762.
  3. Payne AH, Hintz SR, Hibbs AM, et al. Neurodevelopmental outcomes of extremely low-gestational-age neonates with low-grade periventricular-intraventricular hemorrhage. JAMA Pediatr. 2013;167:451–459.
  4. Benders MJ, Kersbergen KJ, de Vries LS. Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 2014;41:69–82.
  5. Rong Z, Liu H, Xia S, Chang L. Risk and protective factors of intraventricular hemorrhage in preterm babies in Wuhan, China. Childs Nerv Syst. 2012;28:2077–2084.
  6. Batton B, Zhu X, Fanaroff J, et al. Blood pressure, anti-hypotensive therapy, and neurodevelopment in extremely preterm infants. J Pediatr. 2009;154:351–357.
  7. Auerbach A, Eventov-Friedman S, Arad I, et al. Long duration of hyperglycemia in the first 96 hours of life is associated with severe intra-ventricular hemorrhage in preterm infants. J Pediatr. 2013;163:388–393.
  8. Alderliesten T, Lemmers PMA, van Haastert I, et al. Hypotension in preterm neonates: Low blood pressure alone does not affect neurode-velopmental outcome. J Pediatr. 2014;164(5):986–991.
  9. Batton B, Li L, Newman NS, et al. Evolving blood pressure dynamics for extremely preterm infants. J Perinatol. 2014;34:301–305.
  10. Faust K, Härtel C, Preuß M, et al. Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life. Am J Perinatol. 2015;32(1):9–14.
  11. Dempsey EM, Barrington KJ, Marlow N, et al. Management of hypotension in preterm infants (The HIP Trial): A randomised controlled trial of hypotension management in extremely low gestational age newborns. Neonatology. 2014;105:275–281.
  12. Batton B, Li L, Newman NS, et al. Use of antihypotensive therapies in extremely preterm infants. Pediatrics. 2013;131:e1865–1873.
  13. Ibrahim H, Sinha IP, Subhedar NV. Corticosteroids for treating hypotension in preterm infants. Cochrane Database Syst Rev. 2011;12:CD003662.
  14. Azhan A, Wong FY. Challenges in understanding the impact of blood pressure management on cerebral oxygenation in the preterm brain. Front Physiol. 2012;3:471.
  15. Batton B, Li L, Newman NS, et al. Early blood pressure, antihypotensive therapy and outcomes at 18–22 months’ corrected age in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed. 2016;101(3):201–216.
  16. Logan JW, O’Shea TM, Allred EN, et al. Early postnatal hypotension and developmental delay at 24 months of age among extremely low gestational age newborns. Arch Dis Child Fetal Neonatal Ed. 2011;96(5):321–328.
  17. Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Data-base Syst Rev. 2006;3:CD004454.
  18. Park CK, Isayama T, McDonald SD. Antenatal corticosteroid therapy before 24 weeks of gestation: A systematic review and meta-analysis. Obstet Gynecol. 2016;127(4):715–725.
  19. Mori R, Kusuda S, Fujimura M. Antenatal corticosteroids promote survival of extremely preterm infants born at 22 to 23 weeks of gestation. J Pediatr. 2011;159:110–114.
  20. Carlo WA, McDonald SA, Fanaroff AA, et al. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22 to 25 weeks’ gestation. JAMA. 2011;306:2348–2358.
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