Intraventricular hemorrhage in preterm newborns: a multicenter study in four Brazilian hospitals

To identify the incidence, demographic characteristics, and risk factors for intraventricular hemorrhage (IVH) in preterm infants admitted to Brazilian neonatal intensive care units (NICUs).

This prospective, observational cohort study was conducted over a one-year period in four NICUs in Brazil. All newborns with gestational age (GA) < 32 weeks or birth weight (BW) < 1500 g, born between September 2023 and September 2024, were included. Demographic data and short-term outcomes were collected. Multinomial logistic regression was performed to evaluate associations between clinical variables and IVH severity.

A total of 268 newborns were enrolled. The mean BW and GA were 1138 g (SD ±388 g) and 29 weeks and 1 day (SD ±3 weeks), respectively. Normal cUS were seen in 54.1%, mild IVH in 20.5%, severe IVH in 10.4%, and 8.2% died prior to a cUS being performed. Infants with the outcome of severe IVH or death prior to cUS exhibited lower BW, GA, Apgar scores, rates of cesarean section, fewer complete courses of antenatal steroids, and were more likely to have undergone advanced resuscitation in the delivery room and significant interventions in the early neonatal period. Hypothermia was prevalent across all groups. Infants with severe IVH had significantly higher rates of death prior to hospital discharge and longer length of stay.

Identifying risk factors for IVH is essential for developing strategies to optimize outcomes. Implementation of a standardized IVH prevention bundle in Brazilian NICUs focusing on factors shown to adversely affect outcomes is warranted.