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Outcome of periventricular-intraventricular haemorrhage at five years of age
M van de Bor1, M Ens-Dokkum, A M Schreuder
1Department of Paediatrics, University Hospital Leiden, The Netherlands.
Insights
Neonatal periventricular-intraventricular haemorrhage in premature infants impacts long-term development. Mild bleeds (grades I/II) were linked to a higher risk of disability at age five.
Area of Science:
- Neonatal neurology
- Pediatric neurodevelopmental outcomes
Background:
- Periventricular-intraventricular haemorrhage (PIVH) is a significant concern in preterm infants.
- Cranial ultrasound is a standard tool for monitoring brain development in neonates.
Purpose of the Study:
- To investigate the association between PIVH in preterm infants and neurodevelopmental outcomes at five years of age.
- To assess the long-term impact of different PIVH grades on disability and handicap.
Main Methods:
- Retrospective analysis of 484 infants (< 32 weeks gestation) undergoing neonatal cranial ultrasound.
- Follow-up assessment of 304 survivors at five years for neurodevelopmental outcomes.
- Categorization of PIVH into mild (grades I/II) and severe (grades III/IV).
Main Results:
- Survival rates were 26% for severe PIVH and 67% for mild PIVH.
- Of the 304 survivors, 85 children had a disability, with 50 experiencing a handicap.
- Children with mild PIVH showed a significantly increased risk of disability at age five.
Conclusions:
- Mild PIVH in preterm infants is associated with a higher risk of long-term neurodevelopmental disability.
- Neonatal PIVH severity influences both survival and functional outcomes in childhood.
- Early detection and monitoring of PIVH are crucial for predicting and managing neurodevelopmental challenges.
Abstract:
The authors studied the relationship between periventricular-intraventricular haemorrhage in infants of < 32 weeks gestation who had undergone routine cranial ultrasound scanning in the neonatal period, and neurodevelopmental outcome at the age of five years. Of 484 infants enrolled into the study, all 304 survivors were available for follow-up at the age of five years. 85 children had a disability; in 50 of these, the disability caused a handicap. Three children with dilated lateral ventricles and no periventricular-intraventricular haemorrhage were excluded from further analyses. 26 per cent of the infants with severe (grades III/IV) haemorrhage and 67 per cent of the infants with mild (grades I/II) haemorrhage survived the neonatal period. Children with mild haemorrhage had a significantly increased risk of disability (including handicap) at the age of five years.