Frequency of Intraventricular Haemorrhage (IVH) in Early Preterm Neonates Born at DHQ Teaching Hospital Gujranwala
DOI:
https://doi.org/10.36552/pjns.v28i1.968Keywords:
Intraventricular HemorrhageAbstract
Objective: The reported frequency of intraventricular hemorrhage in preterm neonates varied greatly. We determined the frequency of IVH in premature neonates in the pediatric unit of DHQ Hospital Gujranwala.
Materials & Methods: This cross-sectional study involved 282 very low birth weight neonates (birth weight <1500 gm.) delivered very preterm (gestational age <32 weeks). These neonates were assessed for intraventricular hemorrhage which was diagnosed on cranial ultrasound performed on 3rd day of life. The frequency of IVH was compared across various attributing factors i.e., gestational age at delivery, gender, birth weight, mode of delivery, and maternal antenatal steroids.
Results: The mean gestational age at delivery was 27.5±2.3 weeks while the mean birth weight was 1120.5±190.2 grams. 172 (61.0%) neonates were delivered vaginally while C-section was performed in 110 (39.0%) cases. 263 (93.3%) mothers received antenatal steroids. Intraventricular hemorrhage was diagnosed in 64 (22.7%) early preterm neonates. The frequency of IVH increased significantly with increasing prematurity; 24-27 weeks vs. 28-31 weeks (28.9% vs. 17.0%; p-value=0.017), decreasing birth weight; <1 kg vs. ?1kg (31.8% vs. 18.6%; p-value=0.014) and lack of antenatal steroids (52.6% vs. 20.5%; p-value=0.001).
Conclusion: The intraventricular hemorrhage was observed in 22.7% of early preterm neonates which advocates routine screening of preterm neonates for IVH so that timely identification and anticipated management may improve the outcome of such neonates. We also identified increasing prematurity, decreasing birth weight, and lack of antenatal steroids as potential attributing factors that can be used for risk stratification and management planning of such cases.
References
de Vries LS, Leijser LM, Nordli Jr. Germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH) in the newborn: prevention, management and complications. J Matern Fetal Neonatal Med. 2015;28(Suppl-1):2273-9.
Szpecht D, Szymankiewicz M, Nowak I, Gadzinowski J. Intraventricular hemorrhage in neonates born before 32 weeks of gestation-retrospective analysis of risk factors. Childs Nerv Syst. 2016;32:1399-1404. https://doi.org/10.1007/s00381-016-3127-x
Ahn SY, Shim SY, Sung IK. Intraventricular hemorrhage and post hemorrhagic hydrocephalus among very-low-birth-weight infants in Korea. J Korean Med Sci. 2015;30(Suppl-1):S52-8.
Doi: 10.3346/jkms.2015.30.S1.S52
Radic JA, Vincer M, McNeely PD. Outcomes of intraventricular hemorrhage and posthemorrhagic hydrocephalus in a population-based cohort of very preterm infants born to residents of Nova Scotia from 1993 to 2010. J Neurosurg Pediatr 2015;15(6):580-8. https://doi.org/10.3171/2014.11.PEDS14364
Kalpakidou AK, Allin MP, Walshe M, Giampietro V, McGuire PK, Rifkin L, et al. Functional neuroanatomy of executive function after neonatal brain injury in adults who were born very preterm. PloS One. 2014;9(12):e113975.
https://doi.org/10.1371/journal.pone.0113975
Ballabh P. Pathogenesis and prevention of intraventricular hemorrhage. Clin Perinatol. 2014;41(1):47-67. Doi: 10.1016/j.clp.2013.09.007
Adegoke SA, Olugbemiga AO, Bankole KP, Tinuade OA. Intraventricular hemorrhage in newborns weighing< 1500 g: Epidemiology and short-term clinical outcome in a resource-poor setting. Ann Trop Med Public Health. 2014;7(1):48.
Haroon A, Maheen H, Salat MS, Dileep D, Ahmed S, Akhtar AS, et al. Risk factors for intraventricular haemorrhage in preterm infants from a tertiary care hospital of Karachi, Pakistan. J Pak Med Assoc. 2014;64(10):1146-50.
Hintz SR, Slovis T, Bulas D, Van meurs KP, Perritt R, Stevenson DK, et al. Interobserver reliability and accuracy of cranial ultrasound scanning interpretation in premature infants. J Pediatr. 2007;150(6):592-6.e5.
Doi: 10.1016/j.jpeds.2007.02.012
Al-Mouqdad MM, Abdelrahim A, Abdalgader AT, Alyaseen N, Khalil TM, Taha MY, et al. Risk factors for intraventricular hemorrhage in premature infants in the central region of Saudi Arabia. Int J Pediatr Adolesc Med. 2019;2(2):1-6.
Henderson J, Carson C, Redshaw M. Impact of preterm birth on maternal well-being and women's perceptions of their baby: a population-based survey. BMJ Open. 2016;6(10):e012676.
https://doi.org/10.1136/bmjopen-2016-012676
Chiruvolu A, Tolia VN, Qin H, Stone GL, Rich D, Conant RJ, et al. Effect of delayed cord clamping on very preterm infants. Am J Obstet Gynecol. 2015;213(5):676.e1-7.
Alan N, Manjila S, Minich N, Bass N, Cohen AR, Walsh M, et al. Reduced ventricular shunt rate in very preterm infants with severe intraventricular hemorrhage: an institutional experience. J Neurosurg Pediatr. 2012;10(5):357-64.
Siddappa AM, Quiggle GM, Lock E, Rao RB. Predictors of severe intraventricular hemorrhage in preterm infants under 29-weeks’ gestation. J Matern Fetal Neonatal Med 2019;7(4):1-6.
Bassiouny MR, Remo C, Remo R, Lapitan R. Intraventricular haemorrhage in premature infants: a study from Oman. J Trop Pediatr 1997;43(3):174-7. Doi: https://doi.org/10.1016/j.ajog.2015.07.016
Khan HS, Khalil S, Akhtar P. Morbidity and mortality pattern of pre-terms. J Islamabad Med Dent Coll. 2016;5(1):77-80.
Hoque MM, Ahmed AS, Halder SK, Khan MF, Chowdhury MA. Morbidities of preterm VLBW neonates and the bacteriological profile of sepsis cases. Pulse. 2010;4(1):5-9.
Egwu CC, Ogala WN, Farouk ZL, Tabari AM, Dambatta AH. Factors associated with intraventricular hemorrhage among preterm neonates in Aminu Kano teaching hospital. Niger J Clin Pract. 2019;22(3):298-304.
Doi: 10.4103/njcp.njcp_154_18
Yakoob MY. Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort. BMC Res Notes. 2019;12(1):620.
https://doi.org/10.1186/s13104-019-4647-8
Hochart A, Nuytten A, Pierache A, Bauters A, Rauch A, Wibaut B, et al. Hemostatic profile of infants with spontaneous prematurity: can we predict intraventricular hemorrhage development? Ital J Pediatr. 2019;45(1):113-9.
https://doi.org/10.1186/s13052-019-0709-8
Sabir S, Ahmed Z, Ahmed I, Razzaq A. Frequency of intraventricular hemorrhage in premature infants. Pak Armed Forces Med J. 2011;61(4):551-4.
Shahid G. Risk factors of subependymal hemorrhage-intraventricular haemorrhage in preterm infants. J Rawal Med Coll. 2017;21(1):23-8.
Wagura P, Wasunna A, Laving A, Wamalwa D. Prevalence and factors associated with preterm birth at Kenyatta national hospital. BMC Pregnancy Childbirth. 2018;18(1):1-8.
https://doi.org/10.1186/s12884-018-1740-2.
Al-QaQa K, Al-Awaysheh F. Neonatal outcome and prenatal antibiotic treatment in premature rupture of membranes. Pak J Med Sci 2005;21(4):441-4.
Larroque B, Marret S, Ancel PY, Arnaud C, Marpeau L, Supernant K, et al. White matter damage and intraventricular hemorrhage in very preterm infants: the EPIPAGE study. J Pediatr. 2003;143(4):477-83. https://doi.org/10.1067/S0022-3476(03)00417-7
Batool SA, Shaheen AN, Naeem MU, Jabeen R, Ahsan Raza SM. To study the prevalence of intra?ventricular hemorrhage in preterm infants. Pak J Med Sci. 2011;5(4):713-5.
Kapoor S, Sharma R, Sapare AK, Aggarwal R. Intraventricular haemorrhage in very preterm neonates. Int J Contemp Pediatr. 2018;5(4):1414-8.
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Copyright (c) 2024 Azher Abbas Shah, Saima Umar, Aysha Ghayyur, Muhammad Arsalan Cheema, Zulfiqar Ali, Saqib Meraj Aslam Bajwa, Saman Shahid, Syed Shahzad HussainThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).