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Updated: Dec 13, 2025
Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
School-age outcomes following intraventricular haemorrhage in infants born extremely preterm
Nicky Laura Hollebrandse1, Alicia J Spittle2,3,4, Alice C Burnett3,5,6,7
1Faculty of Medical Sciences, Rijksuniversiteit Groningen, Groningen, The Netherlands.
Insights
Even mild intraventricular haemorrhage (IVH) in extremely preterm infants is linked to increased cerebral palsy risk. Higher IVH grades correlate with greater risks in motor and intellectual development, but not executive function.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neurodevelopmental outcomes
Background:
- Intraventricular haemorrhage (IVH) is a common complication in extremely preterm infants.
- The long-term neurodevelopmental impact of low-grade IVH (grades 1 and 2) is not fully understood.
- Understanding these associations is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To investigate the association between different grades of intraventricular haemorrhage (IVH) and neurodevelopmental outcomes at 8 years of age.
- Specifically examining the impact of grades 1 and 2 IVH.
- Comparing outcomes in extremely preterm survivors with term-born controls.
Main Methods:
- Population-based cohort study in Victoria, Australia.
- Included extremely preterm survivors (<28 weeks' gestational age) and matched term-born controls.
- Assessed neurodevelopmental outcomes at 8 years, including intellectual ability, executive function, academic skills, cerebral palsy, and motor function, based on the worst neonatal IVH grade.
Main Results:
- A trend for increased motor dysfunction was observed with higher IVH grades (24% with no IVH to 92% with grade 4).
- Children with grade 1 or 2 IVH had a higher risk of cerebral palsy (OR 2.24).
- Higher IVH grades were linked to impairments in intellectual ability and academic skills, but not parental-rated executive function.
Conclusions:
- Low-grade IVH (grades 1 and 2) is associated with an increased risk of cerebral palsy in school-aged children born extremely preterm.
- Higher grades of IVH are associated with greater risks of impairment in motor function and intellectual ability.
- Neurodevelopmental outcomes like executive function, academic skills, and overall motor function show varied associations with IVH severity.
Objective:
To determine the associations of different grades of intraventricular haemorrhage (IVH), particularly grades 1 and 2, with neurodevelopmental outcomes at 8 years of age in children born extremely preterm.
Design:
Population-based cohort study.
Setting:
State of Victoria, Australia.
Patients:
Survivors born at <28 weeks' gestational age (n=546) and matched term-born controls (n=679) from three distinct eras, namely, those born in 1991-1992, 1997 and 2005.
Exposure:
Worst grade of IVH detected on serial neonatal cranial ultrasound.
Outcome Measures:
Intellectual ability, executive function, academic skills, cerebral palsy and motor function at 8 years.
Results:
There was a trend for increased motor dysfunction with increasing severity of all grades of IVH, from 24% with no IVH, rising to 92% with grade 4 IVH. Children with grade 1 or 2 IVH were at higher risk of developing cerebral palsy than those without IVH (OR 2.24, 95% CI 1.21 to 4.16). Increased rates of impairment in intellectual ability and academic skills were observed with higher grades of IVH, but not for grade 1 and 2 IVH. Parent-rated executive functioning was not related to IVH.
Conclusion:
While low-grade IVH is generally considered benign, it was associated with higher rates of cerebral palsy in school-aged children born EP, but not with intellectual ability, executive function, academic skills or overall motor function. Higher grades of IVH were associated with higher rates and risks of impairment in motor function, intellectual ability and some academic skills, but not parental ratings of executive function.
