Risk factors for the deterioration of periventricular\u2013intraventricular hemorrhage in preterm infants

Tian Wu,Yan Wang,Dezhi Mu,Jun Tang,Sheng Huang,Tian Tian,Tao Xiong

doi:10.1038/s41598-020-70603-z

Abstract

Preterm infants with periventricular–intraventricular hemorrhage (PV–IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV–IVH. Previous studies on the pathogenesis of PV–IVH have focused mainly on comparisons of perinatal risk factors between patients with and without PV–IVH. Notably, most cases of PV–IVH occur within the first 3 days after birth, and the condition may worsen within 1 week following the initial diagnosis. However, the risk factors that contribute to the deterioration of PV–IVH have not been investigated. In this cohort study, 514 PV–IVH infants with a gestational age (GA) < 32 weeks were enrolled. The dependent variable was initially diagnosed as mild PV–IVH (grade I or II) that subsequently progressed to severe PV–IVH (grade III or IV) within 1 week. A stepwise forward multivariate logistic regression model was adopted to select potential or related factors that affected the deterioration of PV–IVH in preterm infants. Overall, 42 of the 514 infants with PV–IVH (8.2%) showed deterioration within 1 week. The results showed that maternal lower genital tract infection (OR 3.73, 95% CI 1.75–7.95) was an independent risk factor for PV–IVH deterioration. Higher GA (OR 0.62, 95% CI 0.48–0.80) was a protective factor. Our results suggest that maternal lower genital tract infection and a lower GA may contribute to PV–IVH deterioration in preterm infants.

Highlights

Preterm infants with periventricular–intraventricular hemorrhage (PV–IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV–IVH
Of the 3,783 preterm infants with PV–IVH, the 2,700 infants born at a gestational age (GA) of more than 32 weeks or born in other hospitals were excluded
Of the 813 remaining cases, after infants with initially severe PV–IVH and infants with PV–IVH that progressed from grade I to grade II (n = 100) were excluded, 517 infants who were initially diagnosed with grade I or II PV–IVH remained

Summary

Introduction

Preterm infants with periventricular–intraventricular hemorrhage (PV–IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV–IVH. The risk factors that contribute to the deterioration of PV–IVH have not been investigated In this cohort study, 514 PV–IVH infants with a gestational age (GA) < 32 weeks were enrolled. Our results suggest that maternal lower genital tract infection and a lower GA may contribute to PV–IVH deterioration in preterm infants. Up to approximately 60% of infants with severe PV–IVH (grades III and IV) develop cerebral palsy and/or mental r etardation[5]. These severe sequelae create enormous social and financial burdens. The present study was performed to explore the factors that could potentially contribute to the deterioration of PV–IVH in preterm infants with GA < 32 weeks

Methods

Results

Conclusion