Risk factors in the development of intraventricular haemorrhage in the preterm neonate.

M I Levene, C L Fawer, R F Lamont

One hundred and forty-six infants of 34 weeks' gestation or less were repeatedly scanned by means of real-time ultrasound to diagnose the presence of intraventricular haemorrhage (IVH), its severity, and the timing of onset of the condition. We describe a new method for grading the extent of the IVH which does not depend on ventricular size. IVH was clearly present in 52 (36%) of the 146 infants and in 32 (50%) of the 64 infants of 30 weeks' gestation or less. Repeated scans accurately timed the onset of IVH in 41 infants, and 32 (78%) had the first sign of IVH before 72 hours of age. Thirty-two clinical factors were analysed for possible correlation with the development of IVH: outborn compared with inborn, administration of sodium bicarbonate, hypothermia, intermittent positive pressure ventilation, continuous positive airways pressure, hypercapnia, severe acidosis, and respiratory distress syndrome all reached statistical significance. Analysis of variance showed that respiratory distress syndrome was the most important factor, but severe acidosis had some independent action on the development of IVH. Seventeen (81%) of 21 infants with hypercapnia (PCO2 greater than 6 kPa) together with severe acidosis (pH less than 7.1) developed IVH, of which more than half was moderate or severe in degree.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Chedid, F., Shanteer, S., Haddad, H., Musharraf, I., Shihab, Z., Imran, A., Adma, H. A., Salman, N., Rahmani, A. (2009). Short-Term Outcome of Very Low Birth Weight Infants in a Developing Country: Comparison with the Vermont Oxford Network. J Trop Pediatr 55: 15-19 [Abstract] [Full Text]  
• Hagen, E. W., Sadek-Badawi, M., Carlton, D. P., Palta, M. (2008). Permissive Hypercapnia and Risk for Brain Injury and Developmental Impairment. Pediatrics 122: e583-e589 [Abstract] [Full Text]  
• Hoecker, C., Nelle, M., Poeschl, J., Beedgen, B., Linderkamp, O. (2002). Caffeine Impairs Cerebral and Intestinal Blood Flow Velocity in Preterm Infants. Pediatrics 109: 784-787 [Abstract] [Full Text]  
• Stonestreet, B. S., McKnight, A. J., Sadowska, G., Petersson, K. H., Oen, J. M., Patlak, C. S. (2000). Effects of duration of positive-pressure ventilation on blood-brain barrier function in premature lambs. J. Appl. Physiol. 88: 1672-1677 [Abstract] [Full Text]  
• Mariani, G., Cifuentes, J., Carlo, W. A. (1999). Randomized Trial of Permissive Hypercapnia in Preterm Infants. Pediatrics 104: 1082-1088 [Abstract] [Full Text]  
• Meek, J. H, Tyszczuk, L., Elwell, C. E, Wyatt, J S (1999). Low cerebral blood flow is a risk factor for severe intraventricular haemorrhage. Arch. Dis. Child. Fetal Neonatal Ed. 81: 15F-18 [Abstract] [Full Text]  
• van der Heide, J. C, Paolicelli, P. B, Boldrini, A., Cioni, G. (1999). Kinematic and Qualitative Analysis of Lower-Extremity Movements in Preterm Infants With Brain Lesions. ptjournal 79: 546-557 [Abstract] [Full Text]  
• Morgan, C, Newell, S J, Ducker, D A, Hodgkinson, J, White, D K, Morley, C J, Church, J M (1999). Continuous neonatal blood gas monitoring using a multiparameter intra-arterial sensor. Arch. Dis. Child. Fetal Neonatal Ed. 80: 93F-98 [Abstract] [Full Text]  
• Lupton, B. A., Roland, E. H., Whitfield, M. F., Hill, A. (1990). Serum Sodium Concentration and Intraventricular Hemorrhage in Premature Infants. Arch Pediatr Adolesc Med 144: 1019-1021 [Abstract]  
• de Vries, L. S., Regev, R., Dubowitz, L. M. S., Whitelaw, A., Aber, V R. (1988). Perinatal Risk Factors for the Development of Extensive Cystic Leukomalacia. Arch Pediatr Adolesc Med 142: 732-735 [Abstract]  
• Bor, M. V. D., Bel, F. V., Lineman, R., Ruys, J. H. (1986). Perinatal Factors and Periventricular-Intraventricular Hemorrhage in Preterm Infants. Arch Pediatr Adolesc Med 140: 1125-1130 [Abstract]  
• SEPKOWITZ, S. (1985). Perinatal Risks of Neurodevelopmental Handicaps. Arch Pediatr Adolesc Med 139: 544-544 [Abstract]  
• TeKolste, K. A., Bennett, F. C., Mack, L. A. (1985). Follow-up of Infants Receiving Cranial Ultrasound for Intracranial Hemorrhage. Arch Pediatr Adolesc Med 139: 299-303 [Abstract]  
• Ment, L. R., Ehrenkranz, R. A., Duncan, C. C., Lange, R. C. (1984). Delayed Hemorrhagic Infarction: A Cause of Late Neonatal Germinal Matrix and Intraventricular Hemorrhage. Arch Neurol 41: 1036-1039 [Abstract]  
• Horbar, J. D., Pasnick, M., McAuliffe, T. L., Lucey, J. F. (1983). Obstetric Events and Risk of Periventricular Hemorrhage in Premature Infants. Arch Pediatr Adolesc Med 137: 678-681 [Abstract]