Does ventricular volume affect the neurodevelopmental outcome in infants with intraventricular hemorrhage?

Abstract

The aim of this study is to investigate whether ventricular volume in posthemorrhagic ventricle dilatation impacts neurodevelopmental outcome. Infants were scanned with 3D cranial ultrasound in the first few months of life, and their neurodevelopmental outcome at 4, 8, 12, and 24months corrected age (CA) was examined. Forty-nine infants who suffered an intraventricular hemorrhage (IVH) were enrolled in the study. Subjects were scanned multiple times during their stay in the neonatal intensive care unit. Images were manually segmented to measure total volume of the lateral ventricles, and the highest volume was taken. Infants with a volume ≤ 20cc were considered low-volume (n = 33), and infants with a volume ≥ 40cc were considered high-volume (n = 12). Developmental outcome was assessed at 4, 8, and 12months CA with the Alberta Infant Motor Scale (AIMS) and Infant Neurological International Battery (Infanib), and at 24months CA with the Bayley Scales of Infant Development 3e (BSID III). Infants in the low-volume group had higher scores on the Infanib at 4months CA, and on both the AIMS and Infanib at 8 and 12months CA, even after controlling for gestational age, birth weight, and worst grade of IVH. We observed a trend where low-volume infants also scored higher on the cognitive and gross-motor subtests of the BSID III at 24months CA. Our results show that ventricular volume affects neurodevelopmental outcome in infants with IVH. This finding could guide the timing of future interventions, as earlier intervention may decrease the likelihood of adverse neurodevelopmental outcome.