title: Neurodevelopmental outcome of preterm infants with severe intraventricular hemorrhage and therapy for post-hemorrhagic ventricular dilatation.
abstract: OBJECTIVE
  To evaluate the neurodevelopmental outcome of preterm infants with a grade III or IV hemorrhage and to assess the effect of routine low-threshold therapy of post-hemorrhagic ventricular dilatation (PHVD) on neurodevelopmental outcome.
  
  
  METHODS
  Of the 214 preterm infants (< or = 34 weeks gestational age), 94 (44%) had a grade III intraventricular hemorrhage (IVH), and 120 (56%) had a grade IV hemorrhage. We evaluated the natural evolution of IVH, the need for intervention for PHVD, and neurodevelopmental outcome at 24 months corrected age.
  
  
  RESULTS
  PHVD developed significantly more often in the surviving infants with a grade III hemorrhage (53/68, 78%) than in infants with a grade IV hemorrhage (40/76, 53%; P = .002). Intervention for PHVD was required significantly more often in the grade III group, than in the grade IV group (P < .001). In the grade III group, cerebral palsy developed in 5 of the 68 surviving infants (7.4%), compared with 37 of the 76 infants (48.7%) with a grade IV hemorrhage (P < .001). The mean developmental quotient (DQ) in the grade III group was 99, and in the grade IV-group it was 95 at 24 months corrected age.
  
  
  CONCLUSIONS
  Short-term neurodevelopmental outcome of preterm infants with grade III or IV hemorrhage was better than reported earlier. Requiring intervention for PHVD only had a negative effect on DQ in infants with a grade IV hemorrhage. Infants with cerebral palsy had significantly lower DQs, irrespective of the severity of IVH.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Brouwer
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.forename: Inge-Lot
authors.initials: IL
authors.lastname: van Haastert
authors.forename: Karin
authors.initials: K
authors.lastname: Rademaker
authors.forename: Patrick
authors.initials: P
authors.lastname: Hanlo
authors.forename: Linda
authors.initials: L
authors.lastname: de Vries
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D002552:Cerebral Ventricles; D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome