title: Risk factors associated with post-hemorrhagic hydrocephalus among very low birth weight infants of 24-28 weeks gestation.
abstract: Post-hemorrhagic hydrocephalus (PHH) is associated with morbidity and mortality among very low birth weight (VLBW) infants. This study aimed to determine risk factors for PHH among VLBW infants with peri-intraventricular hemorrhage (PIVH).
  
  
  
  This is a population-based cohort of VLBW infants of 24 to 28 weeks gestation, born in Israel from 1995 to 2012. Infants in whom a brain ultrasound was not performed before 28 days or with major congenital malformations were excluded. Univariate and multivariable analyses identified risk factors associated with PHH.
  
  
  
  The final study cohort comprised 2811 infants with grade 2 or higher PIVH, of whom 610 (21.7%) developed PHH. PHH was independently associated with PIVH severity, with bilateral grade 3 PIVH and PIVH grade 3 and contralateral grade 4 having the highest risks (odds ratio (OR) 12.2, 95% confidence interval (CI) 8.56 to 17.4 and OR 13.7, 95% CI 9.4 to 20.1, respectively). Unilateral grade 3 or 4 PIVH's had moderately increased risks of PHH (OR 3.50, 95% CI 2.26 to 5.42 and OR 3.79, 95% CI 2.35 to 6.12, respectively). PHH was independently associated with increasing gestational age (GA) and with neonatal morbidities including patent ductus arteriosus (OR 1.47, 95% CI 1.15 to 1.88 if medically treated and OR 3.01, 95% CI 2.11 to 4.29 if surgically treated), sepsis (OR 1.79, 95% CI 1.44 to 2.22) and necrotizing enterocolitis (OR 1.60, 95% CI 1.18 to 2.17).
  
  
  
  Among VLBW infants with PIVH, PHH was independently associated with PIVH severity group, increasing GA and acute neonatal morbidities. Unilateral grade 3 or 4 PIVH was associated with a moderate risk of developing PHH compared with bilateral severe hemorrhages.
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.|Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Klinger
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.|Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Osovsky
authors.affiliation: The Women and Children's Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Boyko
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.|Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Sokolover
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.|Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Sirota
authors.affiliation: Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|The Women and Children's Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Lerner-Geva
authors.affiliation: Department of Pediatrics, The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|The Women and Children's Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Reichman
mesh_terms: D002543:Cerebral Hemorrhage / Q000401:mortality*; D002552:Cerebral Ventricles; D015331:Cohort Studies; D016208:Databases, Factual; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality*; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D019102:Infant, Very Low Birth Weight; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D012720:Severity of Illness Index