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Published on: December 31, 2015
Intraventricular Hemorrhage in Very Preterm Infants: A Comprehensive Review
Vianney Gilard1,2, Abdellah Tebani2, Soumeya Bekri2,3
1Department of Pediatric Neurosurgery, Rouen University Hospital, 76000 Rouen, France.
Insights
Germinal matrix-intraventricular-intraparenchymal hemorrhage (GMH-IVH-IPH) affects very preterm infants, often leading to severe complications. Research highlights developmental immaturity and impaired cerebral autoregulation as key causes, suggesting multiomics for better biomarker discovery.
Area of Science:
- Neonatal neurology
- Perinatal medicine
- Developmental neuroscience
Background:
- Germinal matrix-intraventricular-intraparenchymal hemorrhage (GMH-IVH-IPH) is a significant complication in very preterm infants (<32 weeks gestation).
- Incidence remains high before 27 weeks gestation, with risks of hydrocephalus and neurodevelopmental disabilities.
- Understanding pathogenesis is crucial for improving outcomes in this vulnerable population.
Purpose of the Study:
- To provide a comprehensive overview of GMH-IVH-IPH.
- To identify key areas in pathogenesis, complications, neuroprotection, and biomarkers.
- To explore potential avenues for predictive biomarker development.
Main Methods:
- Automated literature search of PubMed (1990-2020) using "Intraventricular hemorrhage" AND "preterm" queries.
- Initial search yielded 1093 articles; 368 were curated and analyzed.
- Clustering approach used to identify key research topics and themes.
Main Results:
- Identified 12 distinct research clusters related to GMH-IVH-IPH.
- Highlighted developmental immaturity of the germinal matrix and impaired cerebral autoregulation as primary pathogenic factors.
- Emphasized the strong association between IVH and subsequent neurodevelopmental impairments.
Conclusions:
- GMH-IVH-IPH pathogenesis is linked to immature germinal matrix and impaired cerebral autoregulation.
- Further multiomics research is needed to develop predictive biomarkers for very preterm newborns.
- Improved understanding can guide neuroprotection strategies and clinical management.
Abstract:
Germinal matrix-intraventricular-intraparenchymal hemorrhage (GMH-IVH-IPH) is a major complication of very preterm births before 32 weeks of gestation (WG). Despite progress in clinical management, its incidence remains high before 27 WG. In addition, severe complications may occur such as post-hemorrhagic hydrocephalus and/or periventricular intraparenchymal hemorrhage. IVH is strongly associated with subsequent neurodevelopmental disabilities. For this review, an automated literature search and a clustering approach were applied to allow efficient filtering as well as topic clusters identification. We used a programmatic literature search for research articles related to intraventricular hemorrhage in preterms that were published between January 1990 and February 2020. Two queries ((Intraventricular hemorrhage) AND (preterm)) were used in PubMed. This search resulted in 1093 articles. The data manual curation left 368 documents that formed 12 clusters. The presentation and discussion of the clusters provide a comprehensive overview of existing data on the pathogenesis, complications, neuroprotection and biomarkers of GMH-IVH-IPH in very preterm infants. Clinicians should consider that the GMH-IVH-IPH pathogenesis is mainly due to developmental immaturity of the germinal matrix and cerebral autoregulation impairment. New multiomics investigations of intraventricular hemorrhage could foster the development of predictive biomarkers for the benefit of very preterm newborns.
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