Relationship between intraventricular hemorrhage and acute kidney injury in premature infants and its effect on neonatal mortality

Mountasser M Al-Mouqdad,Yasmeen S Asfour,Thanaa M Khalil,Suzan S Asfour,Roya Huseynova

doi:10.1038/s41598-021-92746-3

Mountasser M Al-Mouqdad, Yasmeen S Asfour + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-92746-3

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Journal: Scientific Reports	Publication Date: Jun 24, 2021
Citations: 5	License type: open-access

Affiliation: King Saud Medical City

Abstract

Intraventricular hemorrhage (IVH) and acute kidney injury (AKI) are important neonatal morbidities in premature infants. This study aimed to investigate the relationship between IVH and AKI in premature infants and whether this association affects the incidence of neonatal mortality. Infants [gestational age (GA) ≤ 32 weeks; birth weight (BW) < 1500 g] were retrospectively evaluated in a large tertiary neonatal intensive care unit. Of 710 premature infants, 268 (37.7%) developed AKI. Infants with IVH were more likely to have AKI than those without IVH. Infants with severe IVH had a higher incidence of AKI than infants with mild IVH. Infants younger than 28 weeks with IVH were more likely to have AKI than those without IVH. An association between IVH grades and AKI stages was observed in the overall study population, in infants with GA < 28 weeks, and in infants with GA between 28 and 32 weeks. Mortality was increased 1.5 times in infants with IVH and AKI compared with that in infants with IVH but without AKI. Furthermore, mortality was increased in infants with IVH and AKI compared with infants without IVH or AKI. This study shows a direct relationship between the severity of IVH and the degree of AKI; both IVH and AKI increase the incidence of neonatal mortality.

Highlights

Intraventricular hemorrhage (IVH) and acute kidney injury (AKI) are important neonatal morbidities in premature infants
Of 1508 preterm infants with a gestational age (GA) ≤ 32 weeks and a birth weight (BW) > 1500 g who were admitted to the neonatal intensive care unit (NICU, level 3), 710 met the inclusion criteria and were eligible for inclusion in the final analysis (Fig. 1)
After adjusting the relative risk of several independent significant risk factors (GA, BW, 1- and 5-min Apgar scores, pulmonary hemorrhage, expressed breast milk use, and UAC insertion), we found an association between IVH with AKI and an increased risk of mortality versus no IVH or AKI. (Table 5)