Backgrouds and aim Despite the improvement in neonatal care, intraventricular haemorrhage (IVH) remains an important cause of neurodevelopmental anomalies in preterm infants (PI). This event is usually associated with gestational age (GA). Others factors like maternal complications associated with preterm delivery could be implicated. We studied the association between these maternal complications and IVH in a large cohort of PI.
Methods The data were extracted from the national Epipage 2 study, which included PI born before 32 weeks gestation during the year 2011 (n = 3492). Neonatal and Obstetrical data were collected from the medical records including the postnatal cerebral ultrasound results. We used a polytomic logistic regression to compare the risk of the different grades of IVH according to the usual obstetrical complications associated with preterm birth.
Results The incidence of grade 1 IVH was 16.7% [95% CI: 15.2–17.7], grade 2 was 10.5% [95% CI: 9.6–11.6], grade 3 was 5.6% [95% CI: 4.8–6.3] and grade 4: 3.7% [95% CI: 3.1–4.3%]. Infants born when preterm labour with inflammatory syndrome was present had significantly more grade 3 and IV IVH than those exposed to maternal vascular disease (respectively 12.6% and 7.3% vs 1.8% and 3.4%). After adjustment for GA and others confounding factors, grade 4 IVH was strongly associated with preterm labour with inflammation (OR: 1.56 [95% CI: 1.3–18.5]) and placental abruption (OR: 2.3 [95% CI: 1.7–38.0]). Grade 3 IVH was only associated with placental abruption (OR: 4.6 [95% CI: 1.3–16.8]).
Discussion This study demonstrates that IVH is associated with other factors independent of GA, as well as certain maternal complications. These results are useful for the management of preterm birth and help better understand the mechanisms of IVH.
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