Preterm Intraventricular Hemorrhage/Posthemorrhagic Hydrocephalus

Inder, Terrie E.; Perlman, Jeffrey M.; Volpe, Joseph J.

doi:10.1016/b978-0-323-42876-7.00024-7

Cited by 108 publications

(131 citation statements)

References 860 publications

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“…The association between CA and increased risk of HIV is biologically and clinically plausible. IVH generally occurs within the three first days of life and affects the infants with higher hemodynamic and respiratory instability, frequently associated with extreme prematurity and/or severe perinatal infections (2,115). Therefore, the clinical circumstances around birth and during the first days of life are critical for the development of IVH.…”

Section: Discussionmentioning

confidence: 99%

“…As extensively reviewed by Inder et al, the pathogenesis of IVH is multifactorial and may involve intravascular, vascular, and extravascular factors (2). Intravascular factors relate to the regulation of blood flow, pressure, and volume in the microvascular bed of the germinal matrix as well as to platelet-capillary function and blood clotting capability (2). Vascular factors refer to the intrinsic fragility and vulnerability of germinal matrix blood vessels (2).…”

Section: Introductionmentioning

confidence: 99%

“…Vascular factors refer to the intrinsic fragility and vulnerability of germinal matrix blood vessels (2). Extravascular factors include the poor support of the extravascular space surrounding the germinal matrix capillaries, the postnatal decrease in extravascular tissue pressure, and an excessive fibrinolytic activity (2). As assessed by Inder et al, not all the pathogenetic factors are present in every IVH and the clinical circumstances determine which factors are most relevant in each infant (2).…”

Section: Introductionmentioning

confidence: 99%

“…Extravascular factors include the poor support of the extravascular space surrounding the germinal matrix capillaries, the postnatal decrease in extravascular tissue pressure, and an excessive fibrinolytic activity (2). As assessed by Inder et al, not all the pathogenetic factors are present in every IVH and the clinical circumstances determine which factors are most relevant in each infant (2). Among these clinical circumstances, very preterm birth, generally defined as birth before 32 completed weeks of gestation, is the most consistently associated with the development of IVH.…”

Section: Introductionmentioning

confidence: 99%

“…Severe IVH consists of large amounts of intraventricular blood (usually termed grade 3 IVH) and may be complicated by hemorrhagic venous infarction in the periventricular white matter (usually termed grade 4 IVH) or by post-hemorrhagic hydrocephalus or both (1, 2). Severe IVH is associated with increased mortality as well as short-and long-term neurological morbidity, while the long-term neurological outcome of milder forms of IVH (grade 1-2) is still debated and remains an active area of research (1, 2,4) As extensively reviewed by Inder et al, the pathogenesis of IVH is multifactorial and may involve intravascular, vascular, and extravascular factors (2). Intravascular factors relate to the regulation of blood flow, pressure, and volume in the microvascular bed of the germinal matrix as well as to platelet-capillary function and blood clotting capability (2).…”

mentioning

confidence: 99%

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Chorioamnionitis Is a Risk Factor for Intraventricular Hemorrhage in Preterm Infants: A Systematic Review and Meta-Analysis

Villamor-Martínez

Fumagalli

Rahim

et al. 2018

Preprint

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Although chorioamnionitis (CA) is a well-known risk factor for white matter disease of prematurity, the association with intraventricular hemorrhage (IVH) is controversial and has not been yet systematically reviewed. We performed a systematic review and meta-analysis of studies exploring the association between CA and IVH. A comprehensive literature search was conducted using PubMed/MEDLINE and EMBASE, from their inception to 1 July 2017. Studies were included if they examined preterm infants and reported primary data that could be used to measure the association between exposure to CA and the presence of IVH. A random-effects model was used to calculate odds ratios (OR) and 95% confidence intervals (CI). We found 1284 potentially relevant studies, of which 85 met the inclusion criteria (46,244 infants, 13,432 CA cases). Meta-analysis showed that CA exposure was significantly associated with all grades IVH (OR 1.88, 95% CI 1.61-2.19), with grades 1-2 IVH (OR 1.69, 95% CI 1.22-2.34), and with grades 3-4 IVH (OR 1.62, 95% CI 1.42-1.85). Both clinical and histological CA were associated with an increased risk for developing IVH in very preterm infants. In contrast, the presence of funisitis did not increase IVH risk when compared to CA in the absence of funisitis (OR 1.22, 95% CI 0.89-1.67). Further meta-analyses confirmed earlier findings that CA-exposed infants have significantly lower gestation age (GA; mean difference [MD] -1.20 weeks) and lower birth weight (BW; MD -55g) than the infants not exposed to CA. However, meta-regression and subgroup analysis could not demonstrate an association between the lower GA and BW and the risk of IVH in the CA-exposed infants. In conclusion, our data show that CA is a risk factor for IVH, but also a risk factor for greater prematurity and more clinical instability. In contrast to other complications of prematurity, such as patent ductus arteriosus, retinopathy of prematurity, or bronchopulmonary dysplasia, the effect of CA on IVH appears to be independent of CA as causative factor for very preterm birth.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Chorioamnionitis Is a Risk Factor for Intraventricular Hemorrhage in Preterm Infants: A Systematic Review and Meta-Analysis

Villamor-Martínez

Fumagalli

Rahim

et al. 2018

Preprint

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Combining artificial intelligence and conventional statistics to predict bronchopulmonary dysplasia in very preterm infants using routinely collected clinical variables

Montagna,

Magno,

Ferretti

et al. 2024

Pediatric Pulmonology

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BackgroundPrematurity is the strongest predictor of bronchopulmonary dysplasia (BPD). Most previous studies investigated additional risk factors by conventional statistics, while the few studies applying artificial intelligence, and specifically machine learning (ML), for this purpose were mainly targeted to the predictive ability of specific interventions. This study aimed to apply ML to identify, among routinely collected data, variables predictive of BPD, and to compare these variables with those identified through conventional statistics.MethodsVery preterm infants were recruited; antenatal, perinatal, and postnatal clinical data were collected. A BPD prediction model was built using conventional statistics, and nine supervised ML algorithms were applied for the same purpose: the results of the best‐performing model were described and compared with those of conventional statistics.ResultsBoth conventional statistics and ML identified the degree of immaturity (low gestational age and/or birth weight), need for mechanical ventilation, and absent or reversed end diastolic flow (AREDF) in the umbilical arteries as risk factors for BPD. Each of the two approaches also identified additional potentially predictive clinical variables.ConclusionML algorithms might be useful to integrate conventional statistics in identifying novel risk factors, in addition to prematurity, for the development of BPD in very preterm infants. Specifically, the identification of AREDF status as an independent risk factor for BPD by both conventional statistics and ML highlights the opportunity to include detailed antenatal information in clinical predictive models for neonatal diseases.

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Retrieval of germinal zone neural stem cells from the cerebrospinal fluid of premature infants with intraventricular hemorrhage

Fernández‐Muñoz

Rosell‐Valle²,

Ferrari

et al. 2020

Stem Cells Translational Medicine

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Intraventricular hemorrhage is a common cause of morbidity and mortality in premature infants. The rupture of the germinal zone into the ventricles entails loss of neural stem cells and disturbs the normal cytoarchitecture of the region, compromising late neurogliogenesis. Here we demonstrate that neural stem cells can be easily and robustly isolated from the hemorrhagic cerebrospinal fluid obtained during therapeutic neuroendoscopic lavage in preterm infants with severe intraventricular hemorrhage. Our analyses demonstrate that these neural stem cells, although similar to human fetal cell lines, display distinctive hallmarks related to their regional and developmental origin in the germinal zone of the ventral forebrain, the ganglionic eminences that give rise to interneurons and oligodendrocytes. These cells can be expanded, cryopreserved, and differentiated in vitro and in vivo in the brain of nude mice and show no sign of tumoral transformation 6 months after transplantation. This novel class of neural stem cells poses no ethical concerns, as the fluid is usually discarded, and could be useful for the development of an autologous therapy for preterm infants, aiming to restore late neurogliogenesis and attenuate neurocognitive deficits. Furthermore, these cells represent a valuable tool for the study of the final stages of human brain development and germinal zone biology.

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Preterm Intraventricular Hemorrhage/Posthemorrhagic Hydrocephalus

Cited by 108 publications

References 860 publications

Chorioamnionitis Is a Risk Factor for Intraventricular Hemorrhage in Preterm Infants: A Systematic Review and Meta-Analysis

Chorioamnionitis Is a Risk Factor for Intraventricular Hemorrhage in Preterm Infants: A Systematic Review and Meta-Analysis

Combining artificial intelligence and conventional statistics to predict bronchopulmonary dysplasia in very preterm infants using routinely collected clinical variables

Retrieval of germinal zone neural stem cells from the cerebrospinal fluid of premature infants with intraventricular hemorrhage

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