Background/Aim To describe rates and time trends of severe (Grade III/IV) intraventricular haemorrhage (IVH) and cystic periventricular leukomalacia (PVL) and to investigate associated perinatal factors in EuroNeoNet Neonatal Intensive Care Units.
Methods Data from 36,607 VLBWI admitted to 194 NICUs from 19 countries (2006–2012). IVH and PVL rates were separately analysed using logistic regression models for clustered data, with a derivation sample to look for associated factors and a validation sample to verify these (70%/30%). Calibration (Hosmer-Lemeshow test) and discrimination (AUC analysis) were assessed. Significance level was 0.05.
Results There was a marked, significant difference in severe IVH and PVL rates between Northern, Western and Eastern European regions (IVH rates 5%, 9.3% and 14.5% respectively; PVL: 2%, 3.7% 8.8%). Severe IVH and/or PVL had common risk factors: lower GA, 5’ Apgar score, antenatal steroid use, male gender and need for surfactant. PVL was associated with major birth defects, and IVH with vaginal delivery, multiple birth, lower 1’ Apgar score and need for DR resuscitation manoeuvres. A significant time trend to decreasing IVH rates was found in Western countries (from 10.5% in 2006 to 7.3% in 2012) (H-L; ROC (95% CI): Severe IVH: 0.870; 0.805 (0.797 to 0.813); PVL. 0.198; 0.664 (0.649 to 0.679).
Conclusions There is wide variability in IVH and PVL rates across European regions. IVH rates may be decreasing in Western countries. Although both scores could be used to assess quality improvement initiatives, the perinatal model has better predictive value for IVH.
Funded by EC DG-SANCO (Contract number:530078).