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Risk Factors for Developing Hydrocephalus in Neonatal Intraventricular Hemorrhage
Gabriel Flores1, Natalie Amaral-Nieves2, Orlando De Jesús1
1University of Puerto Rico Medical Sciences Campus, San Juan, PR; Section of Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
Puerto Rico Health Sciences Journal
|May 9, 2020
Summary
Severe intraventricular hemorrhage (IVH) in premature infants significantly increases the risk of developing progressive posthemorrhagic hydrocephalus (PPHH). This study identified IVH severity as the primary risk factor for PPHH in Puerto Rican neonates.
Area of Science:
- Neonatal neurology
- Pediatric neurosurgery
- Perinatal medicine
Background:
- Intraventricular hemorrhage (IVH) is a common complication in premature infants.
- Over 50% of survivors develop neurological sequelae, including progressive posthemorrhagic hydrocephalus (PPHH).
- PPHH often necessitates ventriculo-peritoneal (VP) shunting for treatment.
Purpose of the Study:
- To investigate risk factors for PPHH in the neonatal population of Puerto Rico.
- To understand the specific associations between PPHH and variables like gender, gestational age, and birth weight.
Main Methods:
- Retrospective analysis of neonates diagnosed with IVH between 2013 and 2017.
- Data collected included gender, gestational age, birth weight, IVH grade, and need for VP shunt.
- Statistical analysis using Fisher's exact test and binomial logistic regression.
Main Results:
- The study included 261 IVH survivors; mortality rate was 19.4% and PPHH incidence was 7.7%.
- Gender, birth weight, and gestational age were not statistically significant risk factors for PPHH.
- Infants with severe IVH (grades 3 and 4) were 20 times more likely to develop PPHH.
Conclusions:
- The incidence of PPHH in this Puerto Rican cohort was comparable to other populations, with similar mortality rates.
- The severity of the initial intraventricular hemorrhage is the most significant risk factor for developing PPHH.
- Further research may explore specific interventions to mitigate PPHH risk in severe IVH cases.
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