title: Outcomes of extremely preterm infants following severe intracranial hemorrhage.
abstract: OBJECTIVE
  Severe intracranial hemorrhage (ICH) is an important prognostic variable in extremely preterm (EPT) infants. We examined imaging and clinical variables that predict outcomes in EPT infants with severe ICH.
  
  
  METHODS
  Retrospective analysis of 353 EPT infants with severe ICH. Outcomes were compared by examining: (i) unilateral vs bilateral ICH; and (ii) presence vs absence of hemorrhagic parenchymal infarction (HPI). Regression analyses identified variables associated with death or neurodevelopmental impairment (NDI).
  
  
  RESULTS
  Bilateral ICH and HPI had higher rates of adverse outcomes and were independently associated with death/NDI. HPI was the most important variable for infants of lower birth weight, and bilateral ICH for larger infants. For infants surviving to 36 weeks, shunt placement was most associated with death/NDI.
  
  
  CONCLUSIONS
  Bilateral ICH and the presence of HPI in EPT infants with severe ICH are associated with death/NDI, though the importance depends on birth weight and survival to 36 weeks.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Davis
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Hintz
authors.affiliation: Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Goldstein
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: N
authors.initials: N
authors.lastname: Ambalavanan
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Bann
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Stoll
authors.affiliation: Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: E F
authors.initials: EF
authors.lastname: Bell
authors.affiliation: Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shankaran
authors.affiliation: Department of Pediatrics, Brown University, Providence, RI, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Laptook
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: E C
authors.initials: EC
authors.lastname: Hale
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Newman
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Rockville, MD, USA.
authors.forename: A
authors.initials: A
authors.lastname: Das
authors.affiliation: Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Higgins
mesh_terms: D002544:Cerebral Infarction / Q000150:complications* / Q000401:mortality; D002547:Cerebral Palsy / Q000209:etiology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008607:Intellectual Disability / Q000209:etiology; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000401:mortality / Q000473:pathology; D016015:Logistic Models; D012189:Retrospective Studies