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Updated: Dec 12, 2025
Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Risk factors for the deterioration of periventricular-intraventricular hemorrhage in preterm infants
Tian Wu1,2, Yan Wang1,2, Tao Xiong3,4,5
1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Insights
Maternal lower genital tract infection increases the risk of periventricular-intraventricular hemorrhage (PV-IVH) worsening in preterm infants. Higher gestational age (GA) offers protection against PV-IVH progression.
Area of Science:
- Neonatal neurology
- Perinatal medicine
- Pediatric critical care
Background:
- Periventricular-intraventricular hemorrhage (PV-IVH) is a significant risk factor for neurological deficits in preterm infants.
- While perinatal risk factors for PV-IVH are studied, those contributing to its deterioration remain unclear.
- PV-IVH often occurs within days of birth and can worsen within a week, necessitating investigation into progression factors.
Purpose of the Study:
- To identify risk factors associated with the deterioration of periventricular-intraventricular hemorrhage (PV-IVH) in preterm infants.
- To investigate factors influencing the progression from mild (Grade I/II) to severe (Grade III/IV) PV-IVH within one week of initial diagnosis.
Main Methods:
- A cohort study involving 514 preterm infants (gestational age < 32 weeks) diagnosed with PV-IVH.
- Utilized a stepwise forward multivariate logistic regression model to analyze risk factors for PV-IVH deterioration.
- Defined deterioration as progression from mild to severe PV-IVH within 7 days of initial diagnosis.
Main Results:
- Overall, 8.2% (42/514) of infants experienced PV-IVH deterioration within one week.
- Maternal lower genital tract infection was identified as an independent risk factor (OR 3.73, 95% CI 1.75-7.95).
- Higher gestational age (GA) was found to be a protective factor against PV-IVH deterioration (OR 0.62, 95% CI 0.48-0.80).
Conclusions:
- Maternal lower genital tract infection is a significant risk factor for PV-IVH progression in preterm neonates.
- Lower gestational age is associated with a reduced risk of PV-IVH deterioration, indicating a protective effect.
- These findings highlight the importance of monitoring maternal infections and considering GA in managing PV-IVH in preterm infants.
Abstract:
Preterm infants with periventricular-intraventricular hemorrhage (PV-IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV-IVH. Previous studies on the pathogenesis of PV-IVH have focused mainly on comparisons of perinatal risk factors between patients with and without PV-IVH. Notably, most cases of PV-IVH occur within the first 3 days after birth, and the condition may worsen within 1 week following the initial diagnosis. However, the risk factors that contribute to the deterioration of PV-IVH have not been investigated. In this cohort study, 514 PV-IVH infants with a gestational age (GA) < 32 weeks were enrolled. The dependent variable was initially diagnosed as mild PV-IVH (grade I or II) that subsequently progressed to severe PV-IVH (grade III or IV) within 1 week. A stepwise forward multivariate logistic regression model was adopted to select potential or related factors that affected the deterioration of PV-IVH in preterm infants. Overall, 42 of the 514 infants with PV-IVH (8.2%) showed deterioration within 1 week. The results showed that maternal lower genital tract infection (OR 3.73, 95% CI 1.75-7.95) was an independent risk factor for PV-IVH deterioration. Higher GA (OR 0.62, 95% CI 0.48-0.80) was a protective factor. Our results suggest that maternal lower genital tract infection and a lower GA may contribute to PV-IVH deterioration in preterm infants.
