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Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a
Yueju Cai1,2, Yongjiang Jiang2, Ping Wang1
1Department of Neonatology, Guangzhou Wowen and Children's Medical Center, Guangzhou Medical University, 510623, Guangzhou, China.
Insights
Intraventricular hemorrhage (IVH) is common in extremely low birth weight infants (ELBWIs). Prolonged invasive ventilation and vasoactive drug use are key risk factors, necessitating careful respiratory and hemodynamic management.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Critical Care Medicine
Background:
- Intraventricular hemorrhage (IVH) poses a significant risk to extremely low birth weight infants (ELBWIs).
- Early identification of risk factors is crucial for improving outcomes in this vulnerable population.
- This study investigates predictors of early IVH in ELBWIs.
Purpose of the Study:
- To identify risk factors associated with early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs).
- To inform early intervention strategies and improve survival and quality of life for ELBWIs.
- To provide guidance for neonatal care teams managing high-risk infants.
Main Methods:
- Retrospective study of 205 ELBWIs admitted between January 2019 and December 2023.
- Head ultrasound screening (HUS) used to assess IVH presence and severity on days 1-3 and 5-7 post-birth.
- Univariate and logistic regression analyses, with ROC curve evaluation, identified independent risk factors.
Main Results:
- 82 out of 205 ELBWIs (40%) developed IVH, with 12.7% severe and 27.3% mild.
- Severe IVH was significantly more common in infants with lower gestational ages (p < 0.001).
- Independent risk factors identified: failure to withdraw invasive ventilation within the first week (OR=3.276) and use of vasoactive drugs within the first week (OR=2.112).
Conclusions:
- The incidence of IVH in ELBWIs is high, especially within the first three days post-birth.
- Prolonged invasive ventilation and the use of vasoactive drugs are significant risk factors for IVH.
- Careful management of respiratory and hemodynamic support is essential for reducing IVH risk in ELBWIs.
Background:
This study aimed to explore the risk factors for early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs) to provide guidance for early intervention, thereby improving survival rates and quality of life for these vulnerable infants.
Methods:
A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. Standard head ultrasound screening (HUS) was used to assess the presence and severity of IVH on days 1-3 and 5-7 post-birth. Infants were categorized into either the IVH or non-IVH group based on HUS findings. Univariate analysis and logistic regression were employed to identify risk factors for IVH, and the efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve.
Results:
Among the 205 ELBWIs (97 males, 108 females), 82 (40%) developed IVH, with 26 (12.7%) classified as severe IVH and 56 (27.3%) as mild IVH. IVH within the first three days occurred in 51 of the 82 cases. Severe IVH was more prevalent in the lower gestational age groups: 40.0% in infants at 23 + 1 to 26 weeks, 10.7% in infants at 26 + 1 to 28 weeks, and 1.4% in infants at 28 + 1 to 32 weeks (p < 0.001).Logistic regression analysis revealed two independent risk factors: failure to withdraw invasive ventilation within the first week (OR = 3.276, 95% CI = 1.465-7.324, p = 0.004) and the use of vasoactive drugs within the first week (OR = 2.112, 95% CI = 1.002-4.451, p = 0.049). The ROC curve showed a sensitivity of 68.3%, specificity of 81.3%, and an area under the curve (AUC) of 0.792.
Conclusion:
The incidence of IVH in ELBWIs is high, particularly within the first three days after birth. The use of vasoactive drugs and prolonged invasive ventilation are associated with increased risk, highlighting the need for careful management of respiratory and hemodynamic support in these infants.
