Risk Factors Associated with Intraventricular Hemorrhage in Preterm Infants with ≤28 Weeks Gestational Age.
OBJECTIVE
To identify obstetric and neonatal risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) in high-risk preterm neonates.


METHODS
Data from 279 preterm infants (246 mothers) with a gestational age≤28+0 weeks admitted to our NICU between January 2004 and December 2009 were analyzed retrospectively. Occurrence of (GM-IVH) was diagnosed by using ultrasound and important clinical variables were extracted from the patient charts. Infants were divided into 2 groups: GM-IVH and non-GM-IVH. To account for multiple gestation, generalized estimation equations (GEE) were used for univariate analysis and for the evaluation of independent risk factors.


RESULTS
A low 5-min APGAR-Score, multiple birth, low arterial blood pressure at NICU admission, hypercapnia during the first 72 h of life in life and absence of any antenatal corticosteroids were found to be significant independent risk factors in the development of GM-IVH.


CONCLUSIONS
Preterm infants with low arterial blood pressure, absence of antenatal corticosteroids, low 5-min APGAR-Score, higher paCO2 within the first 3 days of life and multiple gestation were at higher risk to develop GM-IVH. Avoiding these risk factors may help to decrease the rate of GM-IVH.
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, University Gießen, Germany.
M
M
Waitz
Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, University Ulm, Germany.
S
S
Nusser
Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, University Ulm, Germany.
M B
MB
Schmid
Institute of Epidemiology and Medical Biometry, Universitat Ulm, Ulm, Germany.
J
J
Dreyhaupt
Department of Obstetrics and Gynecology, Universitat Ulm, Ulm, Germany.
F
F
Reister
Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, University Ulm, Germany.
H
H
Hummler
D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D002552:Cerebral Ventricles; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000209:etiology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors