Periventricular hemorrhagic infarction (PVHI) associated with intraventricular hemorrhage (IVH) in premature infants: Outcome at 2 years of age

Abstract

ObjectiveNeonates can develop periventricular hemorrhagic infarction (PVHI) in association with intraventricular hemorrhage (IVH). The prognosis of this condition remains under debate. The aim of this study was to compare the neurological outcome at 2 years of age for neonates who have IVH with and without PVHI. MethodsThis retrospective single-center study (2010–2017) included all neonates who had at least a grade II IVH on ultrasound (US). The population was divided into two groups: Group 1 had grade II–III IVH without PVHI and Group 2 had grade II–III IVH with PVHI. All clinical and imaging (US and magnetic resonance images) data were reviewed. Neurological sequelae were classified as either mild (favorable outcome), or moderate or severe (unfavorable outcome), based on the follow-up report at the age of 2 years. ResultsA total of 25 of the 46 infants meeting the inclusion criteria were excluded due to missing clinical or imaging data at diagnosis or follow-up. Of the remaining 21 infants, all were preterm and had grade II–III IVH, either with PVHI (n = 10) or without (n = 11). The neurological prognosis was unfavorable for both groups. Except for the size of the lesion, no radiological findings appeared to be significantly associated with an unfavorable prognosis. Overall, 11 of the infants died early in life; i.e., the mortality rate was 52% (n = 11/21). The deaths were not due to neurological complications of prematurity. C-section was more common in the PVHI group. ConclusionPVHI does not appear to be predictive of an unfavorable outcome. Lesion size may be a predictive factor for an unfavorable prognosis in children with PVHI.