title: Variables associated with the decreased risk of intraventricular haemorrhage in a large sample of neonates with respiratory distress syndrome.
abstract: OBJECTIVE
  Prematurity and other risk factors are associated with the development of intraventricular haemorrhage (IVH) in newborns with respiratory distress syndrome (RDS). Conversely, further analysis can determine what characteristics might be associated with a decreased risk of IVH.
  
  
  METHODS
  By using International Classification of Diseases, Ninth Revision, Clinical Modification codes from data obtained from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project from 2000 to 2009, we identified a large number of cases of RDS. Multivariable logistic regression analysis identified potential variables associated with decreased risk of IVH.
  
  
  RESULTS
  Our cohort included 194 621 neonates with RDS, of whom 20 386 (10.5%) developed IVH. Variables associated with decreased risk of both all grades of IVH and severe IVH only included infant of diabetic mother (IDM) status (OR 0.62 (0.54 to 0.70), p<0.001; OR 0.56 (0.42 to 0.74), p<0.001), Trisomy 21 (OR 0.45 (0.30 to 0.69), p<0.001; OR 0.38 (0.16 to 0.93), p=0.034), maternal hypertension (OR 0.62 (0.53 to 0.72), p<0.001; OR 0.28 (0.18 to 0.43), p<0.001), caesarean birth (OR 0.79 (0.74 to 0.84), p<0.001; OR 0.83 (0.73 to 0.94), p<0.001) and, consistent with prior studies, female gender (OR 0.85 (0.82 to 0.88), p<0.001; OR 0.76 (0.72 to 0.80), p<0.001). Polycythaemia (OR 0.67 (0.49 to 0.92), p=0.013; OR 0.79 (0.43 to 1.45), p=0.449) and hypothermia (OR 0.86 (0.75 to 0.99), p=0.039; OR 1.01 (0.81 to 1.28), p=0.903) were associated with lower risk of all IVH but not severe IVH only.
  
  
  CONCLUSIONS
  Previous associations with IVH such as lower birth weight were confirmed. However, infants in whom new variables such as IDM status were present were less likely to develop all IVH grades. Further analysis of these potential protective variables is necessary to better understand the pathophysiology of IVH.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Staten Island, New York, USA.
authors.forename: Harshit
authors.initials: H
authors.lastname: Doshi
authors.affiliation: Departments of Neurology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Moradiya
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Staten Island, New York, USA Departments of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Roth
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Staten Island, New York, USA Departments of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Blau
mesh_terms: D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D002585:Cesarean Section; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology; D004314:Down Syndrome / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D011086:Polycythemia / Q000453:epidemiology; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Neonatology; Neurology; Respiratory