Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: the IVHU study

MacLeod, Rachael; Paulson, Joseph N.; Okalany, Noella; Okello, Francis; Acom, Linda; Ikiror, Juliet; Cowan, Frances; Tann, Cally J; Dyet, Leigh; Hagmann, Cornelia; Burgoine, Kathy

doi:10.1186/s12887-020-02464-4

Cited by 25 publications

(6 citation statements)

References 35 publications

(17 reference statements)

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“…This was statistically signi cant with the IVH occurrence with an OR 3.553 (95% CI 1.584-7.966). This nding was previously reported by Kluckow et al and Miletin et al (7,16) SVCF was signi cantly lower in the catastrophic IVH (grade 3 and 4) group as compared to the no IVH group table (3). That was concordant with Kluckow et al, Miletin et al and Cerbo et al who found that low SVC ow was signi cantly associated with severe degree of IVH.…”

Section: Discussionsupporting

confidence: 89%

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Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring:a prospective cohort study

Farag

Gouda

Almohsen

et al. 2022

Preprint

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Purpose Unstable hemodynamics and prematurity are the main players in IVH development. Our objective was the use of SVCF, LVO and RVO, and ACA Doppler measures in prediction of IVH in the first week of life in preterm infant ≤ 32 weeks.Method Prospective cohort Study in NICU of the Maternity university hospital is presented. Of 147 patients, 132 infants born ≤32 weeks GA were enrolled in the study. 127 completed the study till 7th day of life. Infants were scanned for ACA-RI using transfontanellar ultrasound, and SVC flow, LVO, and RVO using FE in the first 24 hours after birth. Patients had another two scans on DOL3 and7 to detect IVH development. Results Low SVCF and high ACA-RI significantly increased the risk of IVH using logistic regression models with (OR, 3.16; 95%Cl, 1.19 – 8.39; P0.02) and (OR, 1.64; 95%Cl, 1.10 – 2.44;P0.02),respectively. Low SVCF and high ACA-RI significantly increased risk of catastrophic IVH P 0.025 and 0.023, respectively. Combined use Low SVCF < 55 ml/kg/min and ACA-RI > 0.75 is predictor of IVH with sensitivity 40.8% and 82.1% specificity. This work was registered in clinical trial.gv no NCT05050032ConclusionsThere are strong relations between both low SVC flow and high ACA-RI and IVH development in premature neonates ≤32 weeks, with more significance towards catastrophic IVH. Admission RSS and LVO are the strongest factors affecting SVC flow. PDA size (mm/kg) and CRT were significantly associated with high ACA-RI. Theses finding helps in more understanding of pathophysiological factors affecting central perfusion that might affect the longer term neurodeveopmental outcome.

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Section: Discussionsupporting

confidence: 89%

“…In developed countries, there is overall decreased incidence of IVH in preterm infants in the previous 5 decades due to the advances in neonatal intensive care. (2) While in developing countries data are scarce (3) and higher gestational ages and birth weight are included in the risk for IVH.…”

Section: Introductionmentioning

confidence: 99%

Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring:a prospective cohort study

Farag

Gouda

Almohsen

et al. 2022

Preprint

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“…The prevalence finding is similar to that established in other low-income countries, such as Zambia [14] and Uganda [15] with prevalence being slightly above a third in preterm neonates in both studies. This similarity could be because these studies were carried out in similar setting (LMIC) where resources are limited with need to improve perinatal care to put in measures to prevent occurrence of IVH in the preterm population.…”

Section: Discussionsupporting

confidence: 89%

Prevalence of intraventricular haemorrhage and determinants of its early outcomes among preterm neonates at the newborn unit of a teaching hospital in Western Kenya

Sisenda

Njuguna

Nyandiko

2022

Preprint

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Intraventricular haemorrhage (IVH) screened using cranial ultrasounds (cUS) is a major cause of morbidity and mortality among preterm neonates. Despite the adverse neonatal outcomes attributed to IVH, there are limited studies conducted in sub-Saharan Africa on IVH occurrence and determinants of early outcomes. This study assessed the proportion of neonates with IVH, its determinants and the early outcomes of preterm neonates with the condition. A prospective descriptive study conducted at the newborn unit of Moi Teaching and Referral Hospital in Western Kenya between March 2020 to March 2021. The neonates sampled systematically had their clinical characteristics and that of their mothers collected from medical records. A cUS screening was conducted on the third and fourteenth day of life while hydrocephalus was screened using serial weekly measurements of head circumference and mortality assessed within the first 28 days of life. Bivariate analysis was used to test for an association between patient characteristics, occurrence of IVH and early outcomes. Confounders were controlled using a multivariate logistic regression model. We enrolled 201 pre-term neonates of whom 105 (52.2%) were male and 68 (33.8%) had IVH. Among neonates with IVH, 46 (67.6%) had mild while 22 (32.4%) had severe IVH. Antenatal steroids significantly reduced the risk of IVH while extreme/very low gestational age and extremely low birthweight significantly increased the risk of IVH two and three-fold respectively. Neonates with thrombocytopenia and on mechanical ventilation were significantly more likely to be diagnosed with IVH. Early outcomes of IVH were hydrocephalus (4.0%) and mortality (19.1%). Intraventricular hemorrhage was seen in one-third of neonates enrolled with majority of them presenting with the lower IVH grades. The IVH risk significantly increased among neonates with very low gestational age and extremely low birthweight but was lowered by antenatal steroid use. Mortality rates were significantly higher among neonates with thrombocytopenia.

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“…Despite advances in the care of newborns, intraventricular hemorrhage (IVH) remains a common complication in preterm infants, especially in those <32 weeks' gestation ( 1 ). The overall incidence of IVH is about 36% in preterm infants ( 2 ), and the incidence of IVH increases as gestational age and birth weight decrease ( 3 ). It occurs in about 45% of extremely preterm infants with a birth weight of <750 g and in about 52% of preterm infants born at <28 weeks' gestation ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

et al. 2022

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ObjectiveIntraventricular hemorrhage (IVH) is a common complication in preterm infants and is related to neurodevelopmental outcomes. Infants with severe IVH are at higher risk of adverse neurological outcomes and death, but the effect of low-grade IVH remains controversial. The purpose of this study was to evaluate the impact of different degrees of IVH on mortality and neurodevelopmental outcomes in very preterm infants.MethodsPreterm infants with a gestational age of <30 weeks admitted to neonatal intensive care units were included. Cerebral ultrasound was examined repeatedly until discharge or death. All infants were followed up to 18–24 months of corrected age. The impact of different grades of IVH on death and neurodevelopmental disability was assessed by multiple logistic regression.ResultsA total of 1,079 preterm infants were included, and 380 (35.2%) infants had grade I-II IVH, 74 (6.9%) infants had grade III-IV IVH, and 625 (57.9%) infants did not have IVH. The mortality in the non-IVH, I-II IVH, and III-IV IVH groups was 20.1, 19.7, and 55.2%, respectively (p < 0.05), and the incidence of neurodevelopmental disabilities was 13.9, 16.1, and 43.3%, respectively (p < 0.05), at 18–24 months of corrected age. After adjusting for confounding factors, preterm infants with III-IV IVH had higher rates of cerebral palsy [26.7 vs. 2.4%, OR = 6.10, 95% CI (1.840–20.231), p = 0.003], disability [43.3 vs. 13.9%, OR = 2.49, 95% CI (1.059–5.873), p = 0.037], death [55.2 vs. 20.1%, OR = 3.84, 95% CI (2.090–7.067), p < 0.001], and disability + death [73.7 vs. 28.7%, OR = 4.77, 95% CI (2.518–9.021), p < 0.001] compared to those without IVH. However, the mortality and the incidence of neurodevelopmental disability in infants with I-II IVH were similar to those without IVH (p > 0.05).ConclusionsSevere IVH but not mild IVH increased the risk of mortality and neurodevelopmental disability in very preterm infants.

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Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: the IVHU study

Cited by 25 publications

References 35 publications

Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring:a prospective cohort study

Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring:a prospective cohort study

Prevalence of intraventricular haemorrhage and determinants of its early outcomes among preterm neonates at the newborn unit of a teaching hospital in Western Kenya

The Impact of Different Degrees of Intraventricular Hemorrhage on Mortality and Neurological Outcomes in Very Preterm Infants: A Prospective Cohort Study

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