Intraventricular hemorrhage in newborns weighing <1500 g: Epidemiology and short-term clinical outcome in a resource-poor setting

Abstract

Background: Intraventricular hemorrhage (IVH) is a major cause of death and the most important predictor of neurodevelopmetal disabilities in very low birth weight (VLBW) infants. Materials and Methods: Maternal, perinatal and infant data of 87 babies weighing <1500 g who had transfontanelle ultrasonography (TFU) scan were obtained to determine the prevalence, risk factors, features and outcome of IVH by multivariate analyses. Results: The prevalence of IVH was 24.1%. Gestational age <28 weeks; early onset sepsis (EOS) and severe birth asphyxia (SBA) at 5-min were associated with a greater risk of development of IVH. The use of antenatal steroids however reduced the risk. Respiratory distress, clinically identifiable seizures, temperature instability and acidosis, were more common in babies with IVH. Mortality rate was also significantly higher among them (P = 0.005). Babies with severe IVH were 23 times more likely to die than those without IVH (relative risk = 23.3, 95% confidence interval = 1.58-343.42, P = 0.010). Conclusion: The high-rate, morbidity and mortality of IVH emphasize the need for routine TFU scans among VLBW infants. Deliveries before 28 weeks, EOS, failure of antenatal steroids treatment and SBA contributed to the development of IVH. Aggressive prevention/management of these factors are necessary to reduce the burden of IVH in these high-risk neonates.