Article Text
Abstract
Background Intraventricular haemorrhage (IVH) is a significant cause of morbidity and mortality in premature infants. There is a well known correlation between IVH grade and neurodevelopmental outcome. However, to our knowledge, there are only a few studies taking into account the side of the lesion.
Methods Data of 178 infants with grade III IVH with and without parenchymal involvement were retrospectively analysed. Diagnosis was based on cerebral ultrasound. 36% (n = 64) of neonates showed equal IVH severity on both brain sides, the remaining 64% (n = 114) had IVH severity which differed between the hemispheres (right > left, n = 53; left > right, n = 61).
Neurodevelopmental outcome was evaluated at 2 years corrected age via Bayley Scales of Infant development II (BSID II). The data was corrected for influence of gestational age by multiple regression analyses.
Results Mental Development Index (MDI) and Psychomotor Development Index (PDI) were compared between the groups and infants with a larger lesion within the right hemisphere showed statistically significant lower developmental scores at the age of two years (mean (median) ± SD for ‘right > left’ vs. ‘left > right’: MDI 64,2 (54,0) ± 19,6 vs. 78,8 (84,0) ± 17,6 [p = 0,047] and PDI 59,7 (56,5) ± 11,4 vs. 75,9(80,0) ± 17,1 [p = 0,021]).
Conclusion Laterality of IVH has a significant influence on neurodevelopmental outcome in preterm infants. Further studies referring to outcome at school age based on more sophisticated imaging techniques are warranted.