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Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
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Outcomes of extremely preterm infants following severe intracranial hemorrhage

A S Davis1, S R Hintz1, R F Goldstein2

  • 1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 28, 2013
PubMed

Insights

Bilateral intracranial hemorrhage (ICH) and hemorrhagic parenchymal infarction (HPI) in extremely preterm infants are linked to poor outcomes. The significance of these findings varies by birth weight and gestational age.

Area of Science:

  • Neonatal neurology
  • Pediatric neuroimaging
  • Perinatal medicine

Background:

  • Severe intracranial hemorrhage (ICH) is a critical factor influencing outcomes in extremely preterm (EPT) infants.
  • Identifying predictors of adverse outcomes in this vulnerable population is essential for clinical management.

Purpose of the Study:

  • To investigate imaging and clinical variables that predict outcomes in EPT infants diagnosed with severe ICH.
  • To determine the association of unilateral vs. bilateral ICH and the presence/absence of hemorrhagic parenchymal infarction (HPI) with mortality and neurodevelopmental impairment (NDI).

Main Methods:

  • Retrospective analysis of 353 EPT infants with severe ICH.
  • Comparison of outcomes based on ICH laterality (unilateral vs. bilateral) and HPI presence.
  • Regression analyses to identify independent predictors of death or NDI.

Main Results:

  • Bilateral ICH and HPI were independently associated with increased rates of death and NDI.
  • HPI was a significant predictor in lower birth weight infants, while bilateral ICH was more critical in larger EPT infants.
  • Among survivors reaching 36 weeks, shunt placement correlated with higher rates of death/NDI.

Conclusions:

  • Bilateral ICH and HPI are significant indicators of adverse outcomes in EPT infants with severe ICH.
  • The prognostic importance of these findings is modulated by infant birth weight and postmenstrual age at 36 weeks.
Abstract

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