Abstract
Intracerebral hemorrhage in preterm infants is a major cause of brain damage and cerebral palsy. The pathogenesis of cerebral hemorrhage is multifactorial. Among the risk factors are impaired cerebral autoregulation, infections, and coagulation disorders. Machine learning methods allow the identification of combinations of clinical factors to best differentiate preterm infants with intra-cerebral bleeding and the development of models for patients at risk of cerebral hemorrhage. In the current study, a Random Forest approach is applied to develop such models for extremely and very preterm infants (23–30 weeks gestation) based on data collected from a cohort of 229 individuals. The constructed models exhibit good prediction accuracy and might be used in clinical practice to reduce the risk of cerebral bleeding in prematurity.
Highlights
Intraventricular cerebral hemorrhage (IVH) is a frequent complication in preterm infants, affecting the nervous system and leading to impairments of musculoskeletal and cognitive functions, speech development and vision
Occurrence of IVH is strongly associated with thrombocytopenia [22], and, in very low birth weight infants, with an increase in leukocyte count [23]
Leukocyte count and CPR were found to be associated with histological chorioamnionitis [24], which in turn has been identified as a risk factor of IVH [25]
Summary
Intraventricular cerebral hemorrhage (IVH) is a frequent complication in preterm infants, affecting the nervous system and leading to impairments of musculoskeletal and cognitive functions, speech development and vision. The GM is responsible for the formation of immature neuronal and glial cells and disappears by the 32nd week of gestation (WG). According to studies [2,3,4], the most important role is played by the deficient and immature cerebral autoregulation, leading to significant fluctuations in the cerebral blood flow (CBF), as a result of which the fragile, muscle-lacking blood vessels of the GM are destroyed. Various inflammatory diseases that affect the deformability of red blood cells, as well as coagulation disorders were found to be associated with the occurrence of IVH [5, 6]
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