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Published on: November 20, 2015
Perinatal risk factors for pulmonary hemorrhage in extremely low-birth-weight infants
Ting-Ting Wang1, Ming Zhou1, Xue-Feng Hu1
1Department of Neonatology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, #2699, Gaoke western Road, Pudong District, Shanghai, 201204, China.
Insights
Pulmonary hemorrhage (PH) in extremely low-birth-weight infants (ELBWIs) is linked to higher mortality and intraventricular hemorrhage. Early onset sepsis (EOS) is identified as an independent risk factor for PH in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Medicine
- Perinatal Epidemiology
Background:
- Pulmonary hemorrhage (PH) is a critical respiratory complication in extremely low-birth-weight infants (ELBWIs).
- Identifying reliable risk factors for PH in ELBWIs is crucial for improving outcomes.
- Previous studies on PH risk factors in ELBWIs have yielded controversial results.
Purpose of the Study:
- To investigate the perinatal risk factors associated with pulmonary hemorrhage (PH) in extremely low-birth-weight infants (ELBWIs).
- To analyze the short-term clinical outcomes of ELBWIs diagnosed with PH.
- To establish the independent risk factors for PH in this vulnerable population.
Main Methods:
- Retrospective cohort study including live-born infants with birth weights under 1000 grams, surviving at least 12 hours, and without major congenital anomalies.
- Logistic regression modeling was employed to identify significant risk factors for PH.
- Data on perinatal factors and short-term outcomes were collected and analyzed.
Main Results:
- Early onset sepsis (EOS) was identified as an independent risk factor for PH in ELBWIs.
- ELBWIs with PH exhibited significantly higher rates of mortality and intraventricular hemorrhage compared to those without PH.
- No significant differences were observed in rates of periventricular leukomalacia, bronchopulmonary dysplasia, severe retinopathy of prematurity, or hospital stay duration.
Conclusions:
- Pulmonary hemorrhage (PH) in ELBWIs is associated with increased mortality and intraventricular hemorrhage risk.
- Early onset sepsis (EOS) is a key independent risk factor for developing PH in extremely low-birth-weight infants.
- Despite its association with severe outcomes, PH did not significantly impact hospital stay duration or the risk of bronchopulmonary dysplasia.
Background:
Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs). However, the risk factors for PH are controversial. Therefore, the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs.
Methods:
This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g, lived for at least 12 hours, and did not have major congenital anomalies. A logistic regression model was established to analyze the risk factors associated with PH.
Results:
There were 168 ELBWIs born during this period. A total of 160 infants were included, and 30 infants were diagnosed with PH. Risk factors including gestational age, small for gestational age, intubation in the delivery room, surfactant in the delivery room, repeated use of surfactant, higher FiO2 during the first day, invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis. In the logistic regression model, EOS was found to be an independent risk factor for PH. The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH. The rates of periventricular leukomalacia, moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity, and the duration of the hospital stay were not significantly different between the PH and no-PH groups.
Conclusions:
Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia, it increased the mortality and intraventricular hemorrhage rate in ELBWIs. EOS was the independent risk factor for PH in ELBWIs.
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