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Infantile hydrocephalus: declining prevalence in preterm infants
Insights
Infantile hydrocephalus prevalence in very preterm infants increased significantly, then declined. Underlying causes remain key to neurodevelopmental outcomes in affected children.
Area of Science:
- Pediatrics
- Neurology
- Epidemiology
Background:
- Infantile hydrocephalus is a significant concern in pediatric neurology.
- Longitudinal data on its prevalence and etiology in Western Sweden exist since the late 1960s.
- Changes in survival rates of very preterm infants may influence observed prevalence.
Purpose of the Study:
- To analyze trends in infantile hydrocephalus prevalence among preterm and term infants in Western Sweden.
- To investigate the impact of perinatal intraventricular hemorrhage on hydrocephalus rates.
- To assess the relationship between etiology and neurodevelopmental outcomes.
Main Methods:
- Population-based cohort study using birth registry data from Western Sweden.
- Analysis of live birth prevalence of infantile hydrocephalus across different birth year periods (1973-1978, 1983-1986, 1991-1994).
- Categorization by gestational age (very preterm, moderately preterm, term) and etiological factors.
Main Results:
- Live birth prevalence of infantile hydrocephalus in very preterm infants rose from 6.99 to 25.37 per 1000 between 1973-78 and 1983-86.
- Prevalence in very preterm infants declined to 13.69 per 1000 in 1991-94.
- Prevalence remained stable in moderately preterm and term infants, primarily linked to prenatal causes.
- Outcomes in surviving children were consistent with previous findings, emphasizing etiology's role.
Conclusions:
- The fluctuating prevalence of infantile hydrocephalus in very preterm infants is linked to changes in survival rates and perinatal complications like intraventricular hemorrhage.
- Etiology remains the primary determinant of neurodevelopmental impairments in children with infantile hydrocephalus.
- Continued surveillance is crucial for understanding and managing this condition.
Abstract:
The prevalence and aetiological panorama of infantile hydrocephalus in western Sweden have been followed since the late 1960s. A significant increase in the live birth prevalence of very preterm infants with infantile hydrocephalus was found, from 6.99 per 1000 in the birth year period 1973-78 to 25.37 in 1983-86, and owing to an increased survival of very preterm infants with a high risk of hydrocephalus, secondary to an intraventricular haemorrhage occurring in the perinatal period. In the present study covering the birth years 1991-94, a declining prevalence to 13.69 per 1000 very preterm infants was found. In moderately preterm and term groups, mostly with prenatal aetiologies, the prevalence was unchanged. Outcome in surviving children with infantile hydrocephalus remained essentially the same as in previous studies, indicating that the underlying aetiology is the most decisive factor with respect to ensuing neuroimpairments.