Intraventricular hemorrhage and developmental outcomes at 24 months of age in extremely preterm infants.
Whether intraventricular hemorrhage increases the risk of adverse developmental outcome among premature infants is controversial. Using brain ultrasound, we identified intraventricular hemorrhage and white matter abnormalities among 1064 infants born before 28 weeks' gestation. We identified adverse developmental outcomes at 24 months of age using a standardized neurologic examination and the Bayley Scales of Infant Development Mental and Motor Scales. In logistic regression models that adjusted for gestational age, sex, and public insurance, isolated intraventricular hemorrhage was associated with visual fixation difficulty but no other adverse outcome. Infants who had a white matter lesion unaccompanied by intraventricular hemorrhage were at increased risk of cerebral palsy, low Mental and Motor Scores, and visual and hearing impairments. Except when accompanied or followed by a white matter lesion, intraventricular hemorrhage is associated with no more than a modest increase (and possibly no increase) in the risk of adverse developmental outcome during infancy.
Wake Forest School of Medicine, Winston-Salem, NC, USA.
T Michael
TM
O'Shea
Elizabeth N
EN
Allred
Karl C K
KC
Kuban
Deborah
D
Hirtz
Barbara
B
Specter
Sara
S
Durfee
Nigel
N
Paneth
Alan
A
Leviton
D002543:Cerebral Hemorrhage / Q000209:etiology*; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000209:etiology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D006257:Head / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009460:Neurologic Examination; D047928:Premature Birth / Q000503:physiopathology*; D018608:Ultrasonography, Doppler; D014786:Vision Disorders / Q000209:etiology