• Pediatrics · Jan 2014

    Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants.

    • Srinivas Bolisetty, Anjali Dhawan, Mohamed Abdel-Latif, Barbara Bajuk, Jacqueline Stack, Kei Lui, and New South Wales and Australian Capital Territory Neonatal Intensive Care Units' Data Collection.
    • FRACP, Division of Newborn Services, Royal Hospital for Women, Barker Street, Locked Bag 2000, Randwick, 2031 NSW, Australia. Srinivas.Bolisetty@sesiahs.health.nsw.gov.au.
    • Pediatrics. 2014 Jan 1;133(1):55-62.

    ObjectiveNot many large studies have reported the true impact of lower-grade intraventricular hemorrhages in preterm infants. We studied the neurodevelopmental outcomes of extremely preterm infants in relation to the severity of intraventricular hemorrhage.MethodsA regional cohort study of infants born at 23 to 28 weeks' gestation and admitted to a NICU between 1998 and 2004. Primary outcome measure was moderate to severe neurosensory impairment at 2 to 3 years' corrected age defined as developmental delay (developmental quotient >2 SD below the mean), cerebral palsy, bilateral deafness, or bilateral blindness.ResultsOf the 1472 survivors assessed, infants with grade III-IV intraventricular hemorrhage (IVH; n = 93) had higher rates of developmental delay (17.5%), cerebral palsy (30%), deafness (8.6%), and blindness (2.2%). Grade I-II IVH infants (n = 336) also had increased rates of neurosensory impairment (22% vs 12.1%), developmental delay (7.8% vs 3.4%), cerebral palsy (10.4% vs 6.5%), and deafness (6.0% vs 2.3%) compared with the no IVH group (n = 1043). After exclusion of 40 infants with late ultrasound findings (periventricular leukomalacia, porencephaly, ventricular enlargement), isolated grade I-II IVH (n = 296) had increased rates of moderate-severe neurosensory impairment (18.6% vs 12.1%). Isolated grade I-II IVH was also independently associated with a higher risk of neurosensory impairment (adjusted odds ratio 1.73, 95% confidence interval 1.22-2.46).ConclusionsGrade I-II IVH, even with no documented white matter injury or other late ultrasound abnormalities, is associated with adverse neurodevelopmental outcomes in extremely preterm infants.

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