Dwuletnia ocena rozwoju noworodków urodzonych przedwcześnie i hospitalizowanych w ośrodku III stopnia referencji z rozpoznanym krwawieniem około- i dokomorowym II–IV stopnia

Abstract

IntroductionPeriventricular and intraventricular hemorrhage (IVH) in preterm infants may influence their future development. Although the latest foreign publications indicate changing prognosis at different grades of hemorrhage, Polish literature on this topic is scarce. AimTo present relationship between severity of II–IV grade IVH in preterm infants hospitalized in the 3rd level unit and diagnosed with USG, and neurological outcomes at 2 years corrected age. Material and methodsNinety eight infants who had been admitted to the NICU at the Institute of Mother and Child in Warsaw and diagnosed with II–IV grade IVH were observed. Motor, language, cognitive, visual and hearing developments were assessed at 2 years corrected age. ResultsIntensity of neurological impairments increased with grade of hemorrhage and presence of accompanying cystic periventricular leukomalacia (PVL). In children with III grade IVH without PVL, cerebral palsy did not occur. Cerebral palsy, including tetraplegia, was diagnosed mostly in children with IV grade IVH. ConclusionsShort-term evaluation of preterm infants indicates the possibility of occurrence of cerebral palsy in children with II grade IVH. Neurodevelopment of children with III grade IVH is only slightly worse, as long as it is not accompanied by PVL. Prognosis for infants with IV grade IVH is poor in most of the cases and these children should be handled differently from infants with III grade IVH. Brain MRI in selected cases may improve prediction of neurological impairments in this population.