Surgical necrotizing enterocolitis and intraventricular hemorrhage in premature infants below 1000 g.
OBJECTIVE
Infants with very low birth weight are at increased risk for both intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). IVH often progresses in severity after initial diagnosis and causes severe neurological morbidity and mortality. The authors examined the role of NEC in the progression of IVH in these infants.


METHODS
The authors conducted a retrospective case-control study using data from the University of Maryland neonatal intensive care unit database between 1991 and 2003. From a cohort of 957 infants with very low birth weight, 53 pairs of infants labeled as IVH progression versus controls were selected and closely matched in respect to their gestational age and birth weight. Charts from these infants were reviewed to identify risk factors contributing to IVH progression.


RESULTS
Infants with IVH progression were significantly more likely to suffer from NEC (odds ratio, 3.6), whereas infants with surgical NEC showed a greater association with IVH progression (odds ratio, 5.33). Association with thrombocytopenia was also seen (odds ratio, 3.33). Sepsis showed trend toward significance (odds ratio, 1.9; P = .095) for progression of IVH.


CONCLUSIONS
Surgical NEC showed the greatest risk for IVH progression. NEC and thrombocytopenia also appear to be risk factors for IVH progression.
Jen
Howard C
HC
Division of Pediatric Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Graber
Jerome J
JJ
Hill
J Laurance
JL
Alaish
Samuel M
SM
Voigt
Roger W
RW
Strauch
Eric D
ED
D016022:Case-Control Studies; D015897:Comorbidity; D018450:Disease Progression; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000150:complications