title: Intubation Attempts Increase the Risk for Severe Intraventricular Hemorrhage in Preterm Infants-A Retrospective Cohort Study.
abstract: To evaluate whether neonates exposed to multiple intubation attempts within the first 4 days after birth have an increased incidence of intraventricular hemorrhage (IVH).
  
  
  
  This is a retrospective cohort study of infants intubated during the first 4 days after birth. Infants had birth weights (BWs) less than 1500 g and were admitted to the neonatal intensive care unit (NICU) at the University of California, San Diego, between January 1, 2005, and July 30, 2009. A subgroup analysis was done for infants with BW less than 750 g.
  
  
  
  A total of 308 infants with BW <1500 g, including 102 with a BW <750 g, were intubated within the first 4 days of life. The number of intubation attempts was significantly greater in infants with a BW <750 g who had severe IVH compared with those with mild or no IVH (OR 1.395, 95% CI 1.090-1.786, P = .008). For infants with BW <1500 g, the number of intubation attempts in the delivery room was significantly greater for infants with severe IVH (OR 1.317, 95% CI 1.052-1.649, P = .016).
  
  
  
  Increased intubation attempts were associated with increased incidence of severe IVH in infants with BW less than 750 g and in infants less than 1500 g who were intubated only in the delivery room. Prospective studies are needed to further evaluate the relationship between intubation attempts and severe IVH.
authors.affiliation: Department of Pediatrics, University of California, San Diego, CA. Electronic address: csauer@ucsd.edu.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Sauer
authors.affiliation: Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Juin Yee
authors.initials: JY
authors.lastname: Kong
authors.affiliation: Department of Pediatrics, University of California, San Diego, CA.
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Vaucher
authors.affiliation: Department of Pediatrics, University of California, San Diego, CA.
authors.forename: Neil
authors.initials: N
authors.lastname: Finer
authors.affiliation: Clinical and Translational Research Institute, University of California, San Diego, CA.
authors.forename: James A
authors.initials: JA
authors.lastname: Proudfoot
authors.affiliation: Department of Pediatrics, University of California, San Diego, CA.
authors.forename: Mallory A
authors.initials: MA
authors.lastname: Boutin
authors.affiliation: Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Tina A
authors.initials: TA
authors.lastname: Leone
mesh_terms: D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012306:Risk
keywords: Neonatal Intensive Care Unit; delivery room; neonate; resuscitation