Early-onset intraventricular hemorrhage in preterm neonates: incidence of neurodevelopmental handicap.
The neurodevelopmental outcome of very low birth weight infants experiencing early-onset intraventricular hemorrhage (IVH) occurring within the first 6 postnatal hours was compared with that of their peers without early-onset IVH at 3 years corrected age. The 440 surviving preterm infants (birth weight 600 to 1,250 g) who had been enrolled in a multicenter, prospectively randomized, controlled trial evaluating the efficacy of postnatal indomethacin to prevent IVH were evaluated with the Stanford-Binet Intelligence Scale and neurological examinations at 3 years corrected age. All study infants had echoencephalography between 5 and 11 hours of life, and testing is reported for all children residing in English monolingual households at 3 years corrected age (i.e., from the obstetric due date). Fifty five of the 73 (75%) infants with IVH within the first 5 to 11 hours survived to 3 years of age, compared with 385 of the 432 (89%) children without early-onset hemorrhage who were alive at 3 years corrected age (P<.001). Eleven of the 29 (38%) English monolingual children with early-onset IVH had Stanford-Binet intelligence quotient scores of less than 70, compared with 47 of the 249 (19%) children without early IVH (P = .03). Similarly, 7 of 28 (25%) early IVH children were found to have cerebral palsy, compared with 20 of 241 (8%) children without early IVH (P = .01). These data suggest that infants who experience the early onset of IVH are at high risk for both cognitive and motor handicaps at 3 years corrected age.
Department of Pediatrics, Brown University School of Medicine, Providence, RI, USA.
B
B
Vohr
W C
WC
Allan
D T
DT
Scott
K H
KH
Katz
K C
KC
Schneider
R W
RW
Makuch
L R
LR
Ment
D000375:Aging; D001927:Brain Diseases / Q000453:epidemiology* / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000517:prevention & control; D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007361:Intelligence Tests; D011446:Prospective Studies; D014463:Ultrasonography
D007213:Indomethacin