title: Incidence of brain injuries in premature infants with gestational age ≤ 34 weeks in ten urban hospitals in China.
abstract: BACKGROUND
  There is a large number (1.5 million per year) of premature births in China. It is necessary to obtain the authentic incidences of intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL), the common brain injuries, in Chinese premature infants. The present multicenter study aimed to investigate the incidence of brain injuries in premature infants in ten urban hospitals in China.
  
  
  METHODS
  The research proposal was designed by the Subspecialty Group of Neonatology of Pediatric Society of the Chinese Medical Association. Ten large-scale urban hospitals voluntarily joined the multicenter investigation. All premature infants with a gestational age ≤ 34 weeks in the ten hospitals were subjected to routine cranial ultrasound within three days after birth, and then to repeated ultrasound every 3-7 days till their discharge from the hospital from January 2005 to August 2006. A uniform data collection sheet was designed to record cases of brain injuries.
  
  
  RESULTS
  The incidences of overall IVH and severe IVH were 19.7% (305/1551) and 4.6% (72/1551), respectively with 18.4% (56/305) for grade 1, 58.0% (177/305) for grade 2, 17.7% (54/305) for grade 3 and 5.9% (18/305) for grade 4 in nine hospitals. The incidences of overall PVL and cystic PVL were 5.0% (89/1792) and 0.8% (14/1792) respectively, with 84.3% (75/89) for grade 1, 13.5% (12/89) for grade 2, and 2.2% (2/89) for grade 3 in the ten hospitals. The statistically significant risk factors that might aggravate the severity of IVH were vaginal delivery (OR=1.883, 95% CI: 1.099-3.228, P=0.020) and mechanical ventilation (OR=4.150, 95% CI: 2.384-7.223, P=0.000). The risk factors that might result in the development of cystic PVL was vaginal delivery (OR=21.094, 95% CI: 2.650-167.895, P=0.000).
  
  
  CONCLUSIONS
  The investigative report can basically reflect the incidence of brain injuries in premature infants in major big cities of China. Since more than 60% of the Chinese population live in the rural areas of China, it is expected to undertake a further multicenter investigation covering the rural areas in the future.
authors.affiliation: Shanghai Institute for Pediatric Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China. hjchenk@163.com
authors.forename: Hui-Jin
authors.initials: HJ
authors.lastname: Chen
authors.forename: Ke-Lun
authors.initials: KL
authors.lastname: Wei
authors.forename: Cong-Le
authors.initials: CL
authors.lastname: Zhou
authors.forename: Yu-Jia
authors.initials: YJ
authors.lastname: Yao
authors.forename: Yu-Jia
authors.initials: YJ
authors.lastname: Yang
authors.forename: Xiu-Fang
authors.initials: XF
authors.lastname: Fan
authors.forename: Xi-Rong
authors.initials: XR
authors.lastname: Gao
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Liu
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Qian
authors.forename: Ben-Qing
authors.initials: BQ
authors.lastname: Wu
authors.forename: Gao-Qiang
authors.initials: GQ
authors.lastname: Wu
authors.forename: Qing-Mei
authors.initials: QM
authors.lastname: Zhang
authors.forename: Xiao-Lan
authors.initials: XL
authors.lastname: Zhang
mesh_terms: D001930:Brain Injuries / Q000453:epidemiology*; D002681:China; D005260:Female; D005865:Gestational Age; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male