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Occurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and

Zsuzsanna Nagy1,2,3, Mahmoud Obeidat1, Vanda Máté1,4

  • 1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.

JAMA Pediatrics
|January 9, 2025
PubMed

Insights

Intraventricular hemorrhage (IVH) in preterm infants has not changed in overall prevalence since 2007. However, recent studies indicate a later onset of IVH, with fewer cases occurring within the first 6 hours of life.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Clinical Epidemiology

Background:

  • Intraventricular hemorrhage (IVH) is a significant concern in very preterm neonates.
  • The precise timing of IVH onset in the early hours of life (HOL) remains unclear.

Purpose of the Study:

  • To investigate the temporal distribution of intraventricular hemorrhage (IVH) in very preterm neonates.
  • To analyze trends in IVH onset timing over time.

Main Methods:

  • Systematic review and meta-analysis of studies with at least two cranial ultrasounds in the first week of life.
  • Searched PubMed, Embase, Cochrane Library, and Web of Science up to May 2024.
  • Analyzed temporal distribution using pooled time windows (0-6, 0-12, 0-24, 0-48, 0-72 HOL) and compared pre- and post-2007 studies.

Main Results:

  • Included 64 studies with data from 9633 preterm infants.
  • Overall IVH rates (36% vs 31%) and severe IVH rates (10% vs 11%) did not significantly change before vs after 2007.
  • Proportion of IVH within 6 HOL decreased significantly from 35% before 2007 to 9% after 2007.

Conclusions:

  • The overall prevalence of IVH in preterm infants has remained stable since 2007.
  • Recent studies indicate a shift towards a later onset of IVH, with a reduced incidence in the very early hours of life.
Abstract

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