The Epidemiology of Germinal Matrix Hemorrhage During the First Half‐day of Life

Abstract

SUMMARY The personal and maternal characteristics of 27 babies with early‐onset germinal matrix hemorrhage (EGMH) were compared with those of 280 babies with normal cranial ultrasonograms, studied in a separate clinical trial. None of the mothers of the babies with EGMH had high blood pressure or pre‐eclampsia during pregnancy. Gestational age <30 weeks and initial pH <7·2 indicated increased risks of EGMH, and maternal receipt of steroids indicated reduced risk of EGMH. Thus prenatal and immediately perinatal factors appear to convey much of the information about the risk of EGMH. RÉSUMÉ Epidémiologie des hémorragies manifestes de la couche germinative durant la première demi‐journée de vie Les caractéristiques personnelles et maternelles de 27 nourrissons présentant une hémorragie précoce de la couche germinative (EGMH) ont été comparées à celles de 280 nourrissons avec échographies craniennes normales, observés dans un service clinique séparé. Aucune des mères n'avait présenté d'hypertension artérielle ou d'éclampsie durant la grossesse. Un âge conceptuel de moins de 30 semaines et un pH initial inférieur à 7,2 traduisaient un risque accru et l'administration de corticoïdes stéroïdiens a la mère, un risque diminué d'EGMH. Ainsi, les facteurs prénataux et périnataux précoces paraissent fournir l'essentiel de l'information sur le risque d'EGMH. ZUSAMMENFASSUNG Die Epidemiologie von Keimschichtblutungen in den ersten Lebensstunden Von 27 Babies mit früh auftretender Keimschichtblutung (EGMH) wurden die kindlichen und mütterlichen Befunde mit denen von 280 Babies mit normalen cranialen Ultraschallbefunden, die gesondert untersucht wurden, verglichen. Keine der Mütter hatte einen hohen Blutdruck oder eine Praeeklampsie in der Schwangerschaft. Ein Gestationsalter <30 Wochen und ein initialer pH Wert <7·2 bedeutete ein erhöhtes Risiko und eine Steroidtherapie der Mutter ein vermindertes Risiko für EGMH. So scheinen pränatale und perinatale Faktoren viel über das Risiko der EGMH auszusagen. RESUMEN Epidemiologie de la hemorragia de la martiz ferminal evidente durante el primer medio año de vida Se compararon las caractersticas personales y maternas de veintisiete lactantes con hemorragia precoz de la matriz germinal (HPMG), con las de 280 lactantes con ultrasonografia craneal normal, estudiados em dos grupos clinicos separados. Ninguna de las madres habia tenido hipertensión o preeclamsia durante el embarazo. Una edad de gestacion de menos de 30 semanas y un pH inicial inferior a 7,2 indicaban un aumento de riesgo y la recepción materna de esteroides indicaba un riesgo reducido de HPMG. Asi pues, los factores prenatales e inmediatamente perinatales se muestran como indicadores de una gran parte de la información acerca del riesgo de HPMG.

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

“…Because postnatal phenomena, such as the need for ventilation assistance, can be influenced by antepartum phenomena, we created logistic regression models in which risk factors are ordered in a temporal pattern, so that the earliest occurring predictors/covariates of CBCL-DP are entered first and are not displaced by later occurring covariates. 41,42 For these time-oriented risk models (TORMs), we categorize sets of antecedents/covariates by the time they occurred or are identified. We selected variables in each epoch using a manual backwards stepwise selection procedure, in which covariates were removed singly until all predictors in the model were statistically significant (p<.05).…”

Does bronchopulmonary dysplasia contribute to the occurrence of cerebral palsy among infants born before 28 weeks of gestation?

“…Because postnatal phenomena, such as the need for respiratory support, can be influenced by antepartum factors, and these relationships can vary over time,30 we created LR models in which risk factors were ordered in a temporal pattern, so that the earliest occurring predictors/covariates of a CP diagnosis were entered first and those that were significantly associated with the outcome of interest were not displaced by later occurring covariates 13 31–36. For the time-oriented regression models, we categorise sets of antecedents/covariates by the time they occurred or were identified.…”

Antecedents of chronic lung disease following three patterns of early respiratory disease in preterm infants

“…Because postnatal phenomena, such as the need for ventilatory assistance, can be influenced by antepartum phenomena, we created logistic regression models in which risk factors are ordered in a temporal pattern, so that the earliest occurring predictors/covariates of an outcome (eg, CLD) are entered first and are not displaced by later occurring covariates 9–14. For these time-oriented risk models (TORMs), we categorise sets of antecedents/covariates by the time they occur or are identified.…”