Related Experiment Video
Updated: Feb 4, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Risk factors for early mortality and severe intraventricular hemorrhage in extremely preterm infants with gestational
Ziqi Wu1, Yimeng Zhao1, Ruifeng Tian1
1Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Extremely premature infants face high risks of mortality and brain bleeds. Maximum vasoactive-inotropic score (Max VIS), middle cerebral artery resistance index (MCA-RI), and vaginal delivery are key risk factors, while gestational age is protective.
Area of Science:
- Neonatal Medicine
- Perinatal Research
- Pediatric Critical Care
Background:
- Extremely premature infants (EPIs) (<28 weeks gestation) are highly susceptible to mortality and severe intraventricular hemorrhage (IVH).
- Identifying risk factors and predictive markers is crucial for timely intervention and improved outcomes in EPIs.
Purpose of the Study:
- To investigate risk factors for early mortality and severe IVH in EPIs (<28 weeks gestation).
- To evaluate the predictive value of identified risk factors for adverse outcomes in EPIs.
Main Methods:
- Retrospective analysis of clinical data from 293 EPIs (Jan 2019 - Dec 2024).
- Infants categorized into adverse (n=110) and favorable (n=183) outcome groups.
- Binary logistic regression and ROC curve analysis employed to identify risk factors and assess predictive value.
Main Results:
- Independent risk factors for adverse outcomes: elevated maximum vasoactive-inotropic score (Max VIS), increased middle cerebral artery resistance index (MCA-RI), and vaginal delivery.
- Gestational age was identified as a protective factor.
- A combination of Max VIS (>9.5), MCA-RI (>0.81), vaginal delivery, and small gestational age demonstrated the highest predictive performance (AUC=0.833).
Conclusions:
- Elevated Max VIS, increased MCA-RI, vaginal delivery, and small gestational age are significant predictors of adverse outcomes in EPIs.
- The combined assessment of these factors offers valuable clinical guidance for managing high-risk EPIs.
- Early identification and management strategies can be informed by these predictive markers to reduce mortality and severe IVH.
Introduction:
Extremely premature infants (EPIs) are at significant risk for early mortality and severe intraventricular hemorrhage. This study aimed to investigate the risk factors associated with early mortality and severe intraventricular hemorrhage in EPIs with a gestational age of less than 28 weeks and to evaluate the predictive value of these risk factors in determining adverse outcomes.
Methods:
A retrospective analysis was conducted on clinical data from EPIs admitted to the Neonatal Intensive Care Unit at Maternal and Child Health Hospital of Hubei Province between January 2019 and December 2024. Infants were categorized into two groups based on their early outcomes: an adverse outcome group (n = 110) and a favorable outcome group (n = 183). Binary logistic regression analysis was used to identify high-risk factors for adverse outcomes in EPIs, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of these factors.
Results:
This study revealed that the maximum vasoactive-inotropic score (Max VIS) (OR: 1.136, 95% CI: 1.070, 1.216) and middle cerebral artery resistance index (MCA-RI) (OR: 450.489, 95%CI: 36.163, 5,611.780) and vaginal delivery (OR: 3.684, 95%CI: 2.005, 6.768) were independent risk factors for adverse outcomes in EPIs, while gestational age was a protective factor (OR: 0.568, 95% CI: 0.415, 0.778). ROC curve analysis indicated that Max VIS > 9.5, MCA-RI > 0.81, vaginal delivery, and small gestational age had predictive value for adverse outcomes in EPIs (P < 0.05), with area under the curves (AUC) of 0.680 (95% CI: 0.615, 0.745), 0.693 (95%CI: 0.628, 0.758), 0.653 (95% CI: 0.588, 0.718), and 0.660 (95% CI: 0.275, 0.404), respectively. The combination of all four factors yielded the highest predictive performance, with an AUC of 0.833 (95%CI: 0.783, 0.883), sensitivity of 72.7%, and specificity of 81.4%.
Conclusion:
Elevated Max VIS, increased MCA-RI, vaginal delivery, and small gestational age are independent risk factors for early mortality and severe intraventricular hemorrhage in EPIs. Each is a valuable predictor of adverse outcomes, and their combination demonstrates the highest predictive value, providing significant clinical reference for the early management of these high-risk neonates.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:22Diabetes Mellitus: Type 2 and Gestational
01:12Relative Risk
01:22Absolute and Local Extreme Values
01:26Aging
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...