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Incidence and severity of intraventricular hemorrhage: 1981-1984
Insights
Intraventricular hemorrhage (IVH) remains a significant concern for low birthweight infants. While major IVH incidence decreased, overall rates and mortality for minor hemorrhages did not change significantly.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Perinatal Medicine
Background:
- Intraventricular hemorrhage (IVH) is a serious complication in premature infants.
- Understanding trends in IVH incidence and mortality is crucial for improving neonatal care.
Purpose of the Study:
- To analyze the trends in incidence and mortality of intraventricular hemorrhage (IVH) in low birthweight infants between 1981 and 1984.
- To identify changes in IVH rates and outcomes over a four-year period.
Main Methods:
- Retrospective analysis of 407 infants with birthweight ≤ 1500 gm admitted between 1981-1984.
- Data collected included cranial ultrasonograms or autopsy findings, birthweight, gestational age, mode of delivery, and mechanical ventilation requirements.
- IVH was graded (I-IV), and incidence and mortality rates were calculated and analyzed over time.
Main Results:
- No significant trend in overall IVH incidence (ranging from 49-62%) was observed.
- A significant decrease in the incidence of grade III IVH was noted (11% in 1981 to 2% in 1984, P = .01).
- Mortality rates for infants with major IVH (grade III or IV) showed a trend towards decrease (P = .07), while rates for minor IVH remained unchanged.
Conclusions:
- Intraventricular hemorrhage (IVH) continues to be a major challenge in the management of very-low-birthweight infants.
- While a decrease in severe IVH (grade III) and a trend towards reduced mortality in major IVH were observed, overall IVH remains a significant problem.
- Further research and interventions are needed to reduce the burden of IVH in this vulnerable population.
Abstract:
We have examined the trend in the incidence and mortality of intraventricular hemorrhage (IVH) in low birthweight infants from 1981 through 1984. During this time we admitted 407 infants in the first week of life with a birthweight less than or equal to 1500 gm in whom a cranial ultrasonogram or autopsy had been performed. Though the mean birthweight and gestational age, proportion of infants who were inborn, and percentage of infants requiring mechanical ventilation did not change over the 4 years, cesarean deliveries were performed more frequently (P less than .001). The overall incidence of IVH was 62% in 1981, 56% in 1982, 49% in 1983, and 58% in 1984, thus no significant trend was evident. Although the incidence of minor hemorrhages (grades I and II) remained relatively constant, there was a decrease in the incidence of grade III IVH (1981, 11%; 1984, 2%, P = .01). The incidence of grade IV hemorrhage did not change during the 4 years and ranged from 7 to 9%. Mortality rate for all infants weighing less than or equal to 1500 gm and for infants with a minor hemorrhage remained unchanged; however, the mortality rate for infants with a major hemorrhage (grade III or IV) tended to decrease (P = .07). We conclude that although some minor changes in the incidence and mortality have occurred, IVH continues to be a major problem in very-low-birthweight infants at our institution.