Intracranial hemorrhage in asymptomatic neonates: prevalence on MR images and relationship to obstetric and neonatal risk factors.
OBJECTIVE
To retrospectively evaluate the prevalence of neonatal intracranial hemorrhage (ICH) and its relationship to obstetric and neonatal risk factors.


METHODS
Pregnant women were recruited for a prospective study of neonatal brain development; the study was approved by the institutional review board and complied with HIPAA regulations. After informed consent was obtained from a parent, neonates were imaged with 3.0-T magnetic resonance (MR) imaging without sedation. The images were reviewed by a neuroradiologist with 12 years of experience for the presence of ICH. Medical records were prospectively and retrospectively reviewed for selected risk factors, which included method of delivery, duration of labor, and evidence of maternal or neonatal birth trauma. Risk factors were assessed for relationship to ICH by using Fisher exact test statistics.


RESULTS
Ninety-seven neonates (mean age at MR imaging, 20.8 days +/- 6.9 [standard deviation]) underwent MR imaging between the ages of 1 and 5 weeks. Eighty-eight (44 male and 44 female) neonates (65 with vaginal delivery and 23 with cesarean delivery) completed the MR imaging evaluation. Seventeen neonates with ICHs (16 subdural, two subarachnoid, and six parenchymal hemorrhages) were identified. Seven infants had two or more types of hemorrhages. All neonates with ICH were delivered vaginally, with a prevalence of 26% in vaginal births. ICH was significantly associated with vaginal birth (P < .005) but not with prolonged duration of labor or with traumatic or assisted vaginal birth.


CONCLUSIONS
Asymptomatic ICH following vaginal birth in full-term neonates appears to be common, with a prevalence of 26% in this study.
Looney
Christopher B
CB
Department of Psychiatry, CB No. 7160, 7025A Neurosciences Hospital, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7160, USA.
Smith
J Keith
JK
Merck
Lisa H
LH
Wolfe
Honor M
HM
Chescheir
Nancy C
NC
Hamer
Robert M
RM
Gilmore
John H
JH
D001720:Birth Injuries / Q000150:complications; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006408:Hematoma, Subdural / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000175:diagnosis*; D007743:Labor, Obstetric; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis; D013997:Time Factors