Progressive hydrocephalus in infants with birth weights less than 1,500 g

Premature infants have been frequently observed to manifest hydrocephalus after intraventricular hemorrhage (IVH). For the complete newborn population of Nova Scotia in 1976 to 1978, we found a very low incidence of hydrocephalus in children whose birth weight was less than 1,500 g. Eighty-two percent of these babies were born in a perinatal center; 18% were transported. Chart review of survivors (58%) and autopsy review of deaths (autopsy rate, 86%) showed that in the province's three neonatal intensive care units, only four of 314 such babies manifested progressive hydrocephalus. Only one of four infants was examined after IVH. An IVH was noted at autopsy in 42% of cases. No survivor manifested hydrocephalus one to three years later as judged by head circumference and neurosurgical records. Our results may reflect the impact of regionalized perinatal care, or that post-IVH hydrocephalus is rare in an unselected population.