Prenatal risk factors for intraventricular hemorrhage, neonatal death and impaired psychomotor development in very low birth weight infants.
OBJECTIVE
The aim of this study was to determine the relationship between preterm risk factors and neonatal death, cerebral hemorrhage and psychomotor development in very low birth weight infants.


METHODS
A retrospective analysis based on a multivariate logistic regression model was conducted on 253 VLBW infants. Cerebral hemorrhage was assessed by cerebral ultrasound screening within 24 hours of life, psychomotor development by Bailey Psychomotor and Development Index test.


RESULTS
Pre-eclampsia and elective cesarean section (CS) are statistically protective factors in the prevention of cerebral hemorrhage; gestational age is a protective factor for neonatal death; whereas, multiple pregnancy, symmetrically small for gestational-age infants, asphyxia at birth, altered cardiotocography, and cerebral hemorrhage are risk factors for neonatal death; emergency CS and gestational age are protective factors for problems in psychomotor development. The number of fetuses and cerebral hemorrhage are risk factors for impaired psychomotor development at 2 years of age.


CONCLUSIONS
The great number of obstetrical variables related to neonatal outcome makes it difficult to identify the really important steps, in obstetric management, to prevent long term sequelae. The main risk factors related to psychomotor development still remain gestational age and multiple pregnancy.
Section of Obstetrics and Gynecology, Department of Surgical Sciences, University of Udine, Udine, Italy. doctor_d76@hotmail.com
D
D
Pontello
A
A
Ianni
L
L
Driul
M
M
Della Martina
P
P
Veronese
V
V
Chiandotto
R
R
Furlan
F
F
Macagno
D
D
Marchesoni
D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging*; D002585:Cesarean Section / Q000706:statistics & numerical data; D004453:Echoencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007558:Italy / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011596:Psychomotor Disorders / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors